INTERPERSONAL PROBLEMS IN PSYCHODYNAMIC PSYCHOTHERAPY

以前对心理动力心理疗法的研究主要集中在 症状，尽管治疗本身主要涉及人际关系 问题和冲突。这个项目将开发两种新的方法来 心理治疗的人际关系研究--(1) 人际关系问题，一种自我报告工具，用来描述病人的 因人际关系问题而产生的苦恼，以及(2)由群体衍生的 动态提法--一种客观、系统的组合方法 临床医生的独立判断转化为动态的公式，描述 一个病人的人际关系问题。 这项研究中的患者将是即将接受 通过Kaiser-Permanente Medical进行简单的心理动力心理治疗 中心。当他们在等待名单上时，他们将完成一次电池 在两个月内进行了两次问卷调查。那么每个病人都将是 在心理动力吸纳访谈中接受采访，并将被录像 并呈现给一群经验丰富的临床配方师，他们 判断将被合并到一个群体派生的动态公式中。这个 患者将在第十次会议后进行测量，在最后一次会议之后 为期6个月的随访访谈。该设计包括重复设计 对病人的人际关系和症状主诉的评估。 此外，为了增加数据的可靠性，每一次测量都将 涉及多项评估。 这两种方法将用于(1)追踪人际关系和 治疗过程中发生的非人际变化；(2)比较 从人际困扰到症状困扰的变化；(3) 研究患者和治疗师是否变得更加和谐 确定突出的人际问题的会议；及(4)研究 患者对人际关系问题的报告是否越来越多地 与动态公式所建议的相匹配。这也将是可能的 根据病人的人际关系问题对病人进行分类，并 观察不同亚组的治疗进展情况。

Previous studies of psychodynamic psychotherapy have focused on changes in symptoms, though the treatment itself primarily concerns interpersonal problems and conflicts. This project will develop two new methods for studying the interpersonal aspects of psychotherapy--(1) an Inventory of Interpersonal Problems, a self-report instrument for describing a patient's distress arising from interpersonal problems, and (2) a group-derived dynamic formulation, an objective and systematic method of combining clinicians' independent judgment into a dynamic formulation that describes a patients's interpersonal problems. The patients in this study will be men and women who are about to receive brief psychodynamic psychotherapy through the Kaiser-Permanente Medical Center. While they are on the waiting list, they will complete a battery of questionnaires twice over a 2-month period. Then each patient will be interviewed in a psychodynamic intake interview which will be videotaped and presented to a group of experienced clinical formulators whose judgments will be combined into a group-derived dynamic formulation. The patients will then be measured after the tenth session, after the last session, and a 6-month follow-up interview. The design includes repeated assessments of the patient's interpersonal and symptomatic complaints. Also, to increase the reliability of the data, every measurement will involve multiple assessments. The two methods will be used (1) to trace interpersonal and noninterpersonal changes that occur throughout treatment; (2) to compare changes in interpersonal distress to changes in symptomatic distress; (3) to study whether the patient and therapist become more congruent across sessions in identifying salient interpersonal problems; and (4) to study whether a patient's report of interpersonal problems increasingly comes to match that suggested by the dynamic formulation. It will also be possible to classify patients according to their interpersonal problems and to examine the therapeutic progress of different subgroups.