4, 4 after 6 month, 4 after 12 months, 4 after 18 months and 4 after 24 month. The first 4 sessions, the 4 sessions from the 12 th month and the 4 sessions after the 24 th month were assessed with the SWAP- 200. Moreover, all the sessions were also assessed with other two instruments: the Defense Mechanism Rating Scale (DMRS; Perry, 1990) and the Analytic Process Scales (APS; Waldron et al., 2004a, 2004b). The DMRS provide a qualitative and quantitive profile of the defense mechamism more used by the patient and of her overall level of functioning according to a hierarchy of defense levels going from an action level to a mature level, passing for a denial, borderline, narcissistic, neurotic and obsessional level. The APS, finally, enable the assessment of both the patient and the therapist contributions to the therapeutic process and of the quality of their partecipation to the process itself. The application of these empirical tools to the case of Giovanna showed a substantial improvement in her personality functioning and defense maturity and suggested that this improvement could have been facilitated by the explorative interventions of the therapist (clarification and interpretation of conflicts) and by the overall quality of the analyst interventions and his being attuned to the patient’s feeling. Since 2011, in collaboration with the Analytic Process Scales Study Group and the Psychoanalytic Research Consortium (PRC) of New York directed by Sherwood Waldron, Francesco Gazzillo and Vittorio Lingiardi with their research group have started a borader study on the empirical assessment of process and outcome of psychoanalysis. This research project is based on the systematic assessment of 20 audiotaped and transcripted sessions of each of the 31 psychoanalytic treatments of the PRC: the first 4, 4from the 6th month of treatment, 4 from the middle of the therapy, 4 from the 6th week before the termination and the last 4 sessions of each treatment. The first 4+4 sessions are assessed by two independent raters with the Helping Alliance Rating Method (HAR; Luborsky, 1976), the Global Assessment of Functioning Scale (GAF; APA, 2000), and by other two independent raters with the SWAP-200, as well as the Personality Health Index (PHI) and RADIO categories (two SWAP related indexes developed by the APS study group for assessing the level of personality health and some specific personality functioning damains; see Waldron et al., 2011). The last 4+4 sessions are assessed with the same instruments, but not with the HAR. All the sessions are assessed by three independent raters with the APS and the Dynamic Interaction Scales (DIS; Waldron, Gazzillo, Genova, & Lingiardi, 2013). The DIS are twelve rating scales aimed at the empirical assessment of relational and interactional features of patient, therapist and therapeutic couple contributions to the treatment. In the study written by Waldron, Gazzillo, Genova, and Lingiardi (2013) we showed the inter-rater reliability of the DIS and the information obtained by their application to two psychanalytic treatments: the first one is a poor outcome treatment delivered in the seventies by a therapist with an ego psychology orientation, and the second one is a good outcome analysis delivered thirty years later by a therapist with a relational orientation. DIS seem to differentiate correctly the two analytic approaches, and together with the APS seem to suggest that good outcome psychoalyses are characterized by a more sophisticated use of classical analytic interventions (such as clarifications and interpretations of defenses and conflicts), and a more relational attitude of the therapist, i.e. her/his being more avalaible to show her/his subjective thoughts and feeling, a greater contingency with patient’s feelings, etc. Given that the two patients involved in this first study had different personality profiles and that their treatments were delivered by different therapists, in different periods, with different theoretical orientations and different durations, in another study, written by Gazzillo, Waldron, Genova, Angeloni, Ristucci, and Lingiardi (2014), we compared two psychoanalyses delivered in the same period, with comparable lenghts and frequency of sessions, by therapists of the same city, and with the same theoretical orientation, and to patient with a very similar personality profile. One of these treatments had a good outcome, and the second one a poor outcome. Our aim was to verify if the process differences between good and poor outcome psychoanalyses outlined in the 2013 study were confirmed also controlling factors such as the theoretical orientation of the therapist, the frequency of sessions, the length of treatment etc. The results of this study seem to confirm most of the differences highlighted in the first study, showing that good outcome psychoanalyses seem to be carachterized by
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