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! HàD<0*&_!/>_!i)#2*66)*_!/>_!@2%3<0_!=>_!FàDZ2<&_!IE/>_!G!=9<)_!Q>![+,,d^>!@)&0%2()%6!):!(#0!0::07(6!):! (%2*6:0%0*70!$*(0%1%0(2($)*6!$*!3%$0:!&4*29$7!1647#)(#0%214>! '(A?-",-%#@:A&3%(%@#?-O&IbO& -g,h-d->! &)$?-,>-,b,u-,.,PP,,d,--\]+,g! ! K2<&%)*_!Q>_!Q7#2%:_!5>!O>_!HB%6(_!O>_!L$%06(0$*_!Q>!I>_!G!FB%()*_!=>![+,,]^>!K#2(!#2110*6!$*!2! 1647#)2*2<46$6?!=!Y$0Z!(#%)BD#!(#0!<0*6!):!(#0!=*2<4($7!/%)7066!Q72<06![=/Q^>! .+,%#+@,)"+@B&N">#+@B&"!& '(A?-"@+@BA()(O&eJO& ]]Ph]gg>! ! K06(0*_!O>_!G!Q#0&<0%_!i>![-\\\2^>!50Y$6$*D!2*&!266066$*D!=c$6!;;?!;>!O0Y0<)1$*D!2!7<$*$72<<4!2*&!091$%$72<<4! Y2<$&!26606690*(!90(#)&>! 1-%&/$%#)?@+&N">#+@B&"!&'(A?-)@,#AO&IJgO& +.bh+d+>!! ! K06(0*_!O>_!G!Q#0&<0%_!i>![-\\\3^>!50Y$6$*D!2*&!266066$*D!=c$6!;;?!;;>!")Z2%&!2*!091$%$72<<4!3260&!2*&! 7<$*$72<<4!B60:B! /$%#)?@+&N">#+@B&"!&'(A?-)@,#AO&IJgO !+dPh+b.>! W(*&,!>-001(3! The first aim of this article is to report a newly developed measure of therapeutic process, the Dynamic Interaction Scales. When combined with the Analytic Process Scales (Waldron, Scharf, Crouse, et al., 2004; Waldron, Scharf, Hurst, et al., 2004), the two instruments permit a reliable and fine-grained assessment of technical and relational aspects of psychoanalytic and psychodynamic psy- chotherapeutic process. The Shedler-Westen Assessment Procedure and Psy- chological Health Index (Westen & Shedler, 1999a, 1999b; Waldron et al., 2011) permit a reliable and fine-grained assessment of the changes during treatment. The second aim is to demonstrate how combining results from these instruments permits exploring the relationships between processes and out- comes of treatment. We illustrate the utility of this approach by a demonstration project, applying the instruments to two treatments started 21 years apart. The results show different relational and classical approaches of the analysts and different outcomes. Both patients had a similar level of psychological function- ing at the outset of treatment, but one made a much more extensive recovery than the other. The difference in outcomes may reflect different patient pathol- ogy, in spite of their initial level of functioning, but it may also reflect the impact in the better outcome case of a more relational approach, combined with a more extensive use of classical analytic interventions judged to be of higher quality. We then present quantitative results applying the same instruments to 11 additional patients. Technical and relational differences are found between good and poor outcome cases in this group, similar to those found in our two demonstration cases. Ongoing evaluation of an additional 18 cases will permit further study of these differences. @)15-1.*$#! Previous researchers on short-term or even medium-term psychotherapy outcomes have generally not found that therapists’ varying technical contributions to treatment account for much of the differences in outcomes (e.g., Norcross, 2011; Wampold, 2001). By contrast, our findings, if further confirmed in a larger sample, affirm the importance of the therapist’s contribution to benefit. We will have moved closer to confirming what most psychoanalysts have believed for a long time: that both the quality of the analyst’s relationship with the patient and the ability to provide useful verbal communications are crucial therapeutic factors. In other words, the differing emphases of relational and classical theory each have a contribution to the course of treatment that exceeds the benefit of either the relationship alone or interpretation and insight alone. And it seems clear that if, on one hand, interpretations and insights are a function of and happen in the context of a human relationship, on the other hand, a
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