Therapists' responses toward dependent (anaclitic) and self-critical (introjective) depressed outpatients: A multilevel approach.

Drawing on Blatt's theory about personality styles, we examined therapists' affective experiences toward depressed patients with dependent (anaclitic) and self-critical (introjective) personality styles. In addition, we investigated the relationship between therapists' responses, symptom severity, and therapeutic change. Therapists (N = 8) completed the Therapist Response Questionnaire (TRQ) at 5 time points for 50 dependent (anaclitic) and 34 self-critical (introjective) patients (N = 84) over the course of 20-session therapies. Consistent with our predictions, multilevel regression analyses showed that therapists experience stronger responses on the TRQ dimension "parental/protective" toward dependent (anaclitic) patients than toward self-critical (introjective) patients. However, we found no significant relationships between the personality styles and other TRQ dimensions. Furthermore, we found that cognitive-behavioral therapists reported stronger affective responses than psychodynamic therapists. No significant associations were found between the severity of patients' symptoms at the start of treatment and the general intensity of therapists' initial affective experiences, yet therapists experienced stronger emotional reactions when patients made no therapeutic progress. Although further in-depth research on the relationship between therapist responses and patients' personality styles is needed, this study provides partial evidence for Blatt's assertion that the two personality styles are relevant for understanding transference and countertransference processes in therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).