Rorschach correlates of treatment difficulty and of the therapeutic alliance in psychotherapy with female psychiatric hospital patients.

The authors examined the relationship of Rorschach-based rating scales to treatment difficulty and to the therapeutic alliance in the psychotherapy of severely disturbed psychiatric hospital patients. They also examined how the Rorschach measures were related to specific impediments in the patients' ability to form a therapeutic alliance and to improve in the alliance. The statistically significant correlations appear primarily for women. The findings of central interest are: (1) Female patients with better thought organization and object relations capacities, as measured by the Rorschach, tend to be more difficult to treat; (2) those women who manifest higher Aggression-Malevolence scores on the Rorschach tend to have better therapeutic alliances; and (3) improvement in the therapeutic alliance with female patients is significantly related to higher severity of psychological disturbance on the Rorschach test.