Success and failure in time-limited psychotherapy. A systematic comparison of two cases: comparison 2.

This is the second article in a series comparing two patients treated in time-limited individual psychotherapy by a professional therapist in the Vanderbilt Psychotherapy Project. The patients were two young men suffering from anxiety, depression, and social withdrawal. One of the patients was a success case, the other a therapeutic failure. In addition to a variety of change measures, all tape-recorded therapy sessions were subjected to intensive study. Results showed that the outcome of psychotherapy depends markedly on the patient's ability to form a productive working relationship with the therapist early in therapy. Conversely, deep-seated characterological problems, manifesting themselves particularly in negativism, hostility, and other resistances, may give rise to insurmountable barriers resulting in negative therapeutic outcomes. The therapist's attitudes toward the patient and technical skill obviously play a part, but they appear to be overshadowed by the foregoing patient variables.