Joyce A S, Piper W E
Department of Psychiatry, University of Alberta Hospitals, Edmonton.
Can J Psychiatry. 1990 Feb;35(1):41-9. doi: 10.1177/070674379003500107.
The present study attempted a sensitive test of the dynamic sequence proposed by Mann for time-limited individual psychotherapy (TLP). Session evaluation ratings were collected from both patient and therapist. Indices were constructed that reflected the consistency of patient ratings, the consistency of therapist ratings, and the congruence between patient and therapist ratings, in each third of TLP. Measures of symptoms and social functioning were employed to differentiate cases of "good" versus "poor" treatment outcome. Therapists' adherence to the TLP technique was assessed by categorizing all interventions in each session. Fourteen patients were treated according to the TLP model. Measures of therapist behaviour indicated that treatments had been conducted in general accordance with Mann's technical recommendations. Measures of consistency and congruence failed to support the proposed TLP dynamic sequence. Analyses of mean evaluation ratings indicated a trend towards more positive evaluations as therapy progressed; "good" outcome cases were significantly more likely to evidence this pattern. Results are discussed in terms of interplay between inductive hypothesis building and empirical verification in the development of theories of psychotherapy.
本研究尝试对曼恩提出的限时个体心理治疗（TLP）的动态序列进行敏感性测试。收集了患者和治疗师的 session 评估评分。构建了反映 TLP 每三分之一阶段中患者评分的一致性、治疗师评分的一致性以及患者与治疗师评分的一致性的指标。采用症状和社会功能测量方法来区分“良好”与“不良”治疗结果的病例。通过对每个 session 中的所有干预措施进行分类，评估治疗师对 TLP 技术的依从性。根据 TLP 模型对 14 名患者进行了治疗。治疗师行为测量表明，治疗总体上是按照曼恩的技术建议进行的。一致性和一致性测量未能支持所提出的 TLP 动态序列。平均评估评分分析表明，随着治疗的进展，评估有更积极的趋势；“良好”结果的病例更有可能出现这种模式。在心理治疗理论发展中归纳假设构建与实证验证之间的相互作用方面对结果进行了讨论。
