Joyce A S, Piper W E
Department of Psychiatry, University of Alberta, Edmonton, Canada.
J Consult Clin Psychol. 1996 Jun;64(3):505-12. doi: 10.1037//0022-006x.64.3.505.
"Work" and "resistance" responses to interpretation in short-term individual (STI) psychotherapy were examined using a hierarchical linear modeling (HLM) procedure. The relationships between interpretation characteristics and patient responses within therapy were considered. Process data were drawn from 60 STI therapy cases, 30 patients with low quality of object relations (QOR), and 30 patients with high QOR. In 4 instances, the relationships between technique and response were found to vary significantly across cases. One was identified for low QOR patients, and 3 were identified for high QOR patients. Individual differences in initial disturbance and outcome were used to account for the variation of technique-response relationships. Significant findings were limited to the high QOR sample. Initial disturbance was directly related to work in response to a transference-oriented approach. The transference focus-work relationship was found to be inversely related to outcome. The results extend previous findings regarding transference technique in STI therapy with high QOR patients. Through capitalizing on within-case variation, HLM can be used to illuminate process-outcome relationships in psychotherapy.
采用分层线性模型（HLM）程序，对短期个体（STI）心理治疗中对阐释的“工作”和“阻抗”反应进行了研究。研究了治疗过程中阐释特征与患者反应之间的关系。过程数据取自60个STI治疗案例，其中30名患者的客体关系质量（QOR）较低，30名患者的QOR较高。在4个案例中，发现技术与反应之间的关系在不同案例中有显著差异。其中1个案例是针对QOR较低的患者，3个案例是针对QOR较高的患者。初始困扰和治疗结果的个体差异被用来解释技术-反应关系的变化。显著发现仅限于QOR较高的样本。初始困扰与对以移情为导向的方法的工作直接相关。发现移情焦点-工作关系与治疗结果呈负相关。这些结果扩展了先前关于STI治疗中QOR较高患者的移情技术的研究发现。通过利用案例内的变异，HLM可用于阐明心理治疗中的过程-结果关系。
