Taking Context Seriously in Psychotherapy Research: Relating Therapist Interventions to Patient Progress in Brief Psychodynamic Therapy

This study examined the process of brief psychodynamic therapy in a way that preserved the context of the dialogue between therapist and patient. Data were drawn from transcripts of the complete therapies of 2 anxious and depressed women, which lasted 16 to 17 sessions. Patient utterances were rated on a psychodynamically oriented progress-stagnation scale, and all therapist interventions were rated on scales measuring (a) their compatibility with the content of a psychodynamic formulation (Plan) and (b) their quality. Within-session sequential analyses and by session and by phase-of-therapy correlational analyses were performed. Plan compatibility of therapist interventions correlated significantly with patient progress in the early and middle phases, and the quality of therapist interventions correlated significantly with patient progress in the middle phase.