Manual for transference work scale; a micro-analytical tool for therapy process analyses

Background The present paper is a manual for the Transference Work Scale (TWS). The inter-rater agreement on the 26 TWS items was good to excellent and previously published. TWS is a therapy process rating scale focusing on Transference Work (TW) (i.e. analysis of the patient-therapist relationship). TW is considered a core active ingredient in dynamic psychotherapy. Adequate process scales are needed to identify and analyze in-session effects of therapist techniques in psychodynamic psychotherapy and empirically establish their links to outcome. TWS was constructed to identify and categorize relational (transference) interventions, and explore the in-session impact of analysis of the patient-therapist relationship (transference work). TWS has sub scales that rate timing, content, and valence of the transference interventions, as well as response from the patient. Methods Descriptions and elaborations of the items in TWS are provided. Clinical examples of transference work from the First Experimental Study of Transference Interpretations (FEST) are included and followed by examples of how to rate transcripts from therapy sessions with TWS. Results The present manual describes in detail the rating procedure when using Transference Work Scale. Ratings are illustrated with clinical examples from FEST. Conclusion TWS might be a potentially useful tool to explore the interaction of timing, category, and valence of transference work in predicting in-session patient response as well as treatment outcome. TWS might prove especially suitable for intensive case studies combining quantitative and narrative data. Trial registry name First Experimental Study of Transference-interpretations (FEST307/95). Registration number: ClinicalTrials.gov Identifier: NCT00423462 . URL: http://clinicaltrials.gov/ct2/show/NCT00423462?term=FEST&rank=2

Does Insight Mediate Treatment and Enhance Outcome?

According to psychoanalytic and psychodynamic theory, insight is an important mechanism which may lead to better interpersonal functioning. In the present paper we have summarized empirical studies attempting to shed some light on insight as a putative mediator of treatment effects. Two case examples illustrate how improved insight might lead to clinical change. This is an Accepted Manuscript of an article published by Taylor & Francis : http://www.tandfonline.com

Psykodynamisk kartlegging av ungdom og voksne ved hjelp av semistrukturert intervju og funksjonsskalaer

Få redskaper finnes for å kartlegge og evaluere dynamisk endring i forbindelse med psykodynamisk terapi. Psykodynamiske funksjonsskalaer (PFS) er revidert og oversatt til norsk. Basert på et psykodynamisk intervju er skalaene egnet for kartlegging av dynamisk fingering hos ungdom og voksne. I denne artikkelen presenteres en revidert versjon av PFS som er oversatt fra engelsk til norsk. En guide for det semistrukturerte intervjuet er også inkludert. Dette verket har følgende lisens: Erkännande-Ickekommersiell-IngaBearbetningar 2.5 Sverige (CC BY-NC-ND 2.5 SE

Relational interventions in psychotherapy: development of a therapy process rating scale

Background In psychodynamic psychotherapy, one of the therapists’ techniques is to intervene on and encourage exploration of the patients’ relationships with other people. The impact of these interventions and the response from the patient are probably dependent on certain characteristics of the context in which the interventions are given and the interventions themselves. To identify and analyze in-session effects of therapists’ techniques, process scales are used. The aim of the present study was to develop a simple, not resource consuming rating tool for in-session process to be used when therapists’ interventions focus on the patients’ relationships outside therapy. Methods The present study describes the development and use of a therapy process rating scale, the Relational Work Scale (RWS). The scale was constructed to identify, categorize and explore therapist interventions that focus on the patient’s relationships to family, friends, and colleges Relational Interventions and explore the impact on the in-session process. RWS was developed with sub scales rating timing, content, and valence of the relational interventions, as well as response from the patient. For the inter-rater reliability analyzes, transcribed segments (10 min) from 20 different patients were scored with RWS by two independent raters. Two clinical vignettes of relational work are included in the paper as examples of how to rate transcripts from therapy sessions with RWS. Results The inter-rater agreement on the RWS items was good to excellent. Conclusion Relational Work Scale might be a potentially useful tool to identify relational interventions as well as explore the interaction of timing, category, and valence of relational work in psychotherapies. The therapist’s interventions on the patient’s relationships with people outside therapy and the following patient-therapist interaction might be explored. Trial registration First Experimental Study of Transference-interpretations (FEST307/95) Registration number: ClinicalTrials.gov Identifier: NCT00423462

Assessment of dynamic change in psychotherapy with asdolescents

Background Diagnostic interviews and questionnaires are commonly used in the assessment of adolescents referred to child and adolescent mental health services. Many of these rating scales are constructed for adults and focus on symptoms related to diagnosis. Psychodynamic Functioning Scales (PFS) focus on relational aspects and how the patients handle affects and solve problems, rather than manifest symptoms. As these aspects are considered important for mental health, the PFS were developed to assess change in adults, consistent with the relational and intrapsychic concepts of dynamic psychotherapy. The scales describe internal predispositions and psychological resources that can be mobilized to achieve adaptive functioning and life satisfaction. PFS consist of six subscales; the relational subscales Family, Friends and Romantic/Sexual relationships and the dynamic subscales Tolerance for Affects, Insight and Problem-solving Capacity. PFS has been used for the first time as a measure of change in adolescent psychotherapy. This study examines the reliability of PFS when used to assess adolescents’ level of relational functioning, affective tolerance, insight, and problem-solving capacities. Methods Outpatient adolescents 16–18 years old with a major depressive disorder were included in the First Experimental Study of Transference work in Teenagers (FEST-IT). They were evaluated before and after time-limited psychodynamic psychotherapy with an audio-recorded semi-structured psychodynamic interview. Based on the audio-tapes, raters with different clinical background rated all the available interviews at pre-treatment (n = 66) and post-treatment (n = 30) using PFS. Interrater reliability, the reliability of change ratings and the discriminability from general symptoms were calculated in SPSS. Results The interrater reliability was on average good on the relational subscales and fair to good on the dynamic subscales. All pre-post changes were significant, and the analyses indicated discriminability from general symptoms. The interrater reliability on PFS (mean) and Global Assessment of Functioning were good to excellent. Conclusion Based on the interrater reliability in our study, PFS could be recommended in psychotherapy with adolescents by experienced clinicians without extensive training. From the post-treatment evaluations available, the scales seem to capture statistically and clinically significant changes. However, the interrater reliability on dynamic subscales indicates that subscales of PFS might be considered revised or adjusted for adolescents. Trial registration First Experimental Study of Transference-Work-In Teenagers (2011/1424 FEST-IT). ClinicalTrials.gov Identifier: NCT0153110

Additional file 1: of Relational interventions in psychotherapy: development of a therapy process rating scale

Relational Work Scale (RWS). (DOCX 16 kb