Psychotherapy process research is continuously gaining importance since the interaction between therapist and patient is of crucial relevance for a successful therapy. However, knowledge of specific processes effectively enabling therapeutic change is still limited.
The relation between alliance and outcome of psychotherapy has been confirmed across hundreds of studies (Flückiger et al. 2018). However, studies addressing the role of specific therapeutic techniques, specific patient characteristics or specific patient-therapist interactions in this association are rare. The present study aims to examine the influence of two promising variables, i.e. patients’ level of reflective functioning (Bateman and Fonagy, 2019) and therapists’ performance concerning patients’ unconscious tests (Weiss & Sampson, 1986) and their interaction, while simultaneously addressing the interaction with more well-established influence factors, i.e. therapeutic alliance and technique (e.g. Owen & Hilsenroth 2011).
Within the framework of the Munich Psychotherapy Study (Huber et al., 2012), patients treated with psychoanalytic, psychodynamic or cognitive-behavioral therapy will be investigated. For each case, sessions from the beginning, the middle and the end of the therapy will be analyzed. Patients’ level of reflective functioning will be rated based on the Reflective Functioning Scale (Fonagy et al., 1998). Therapists’ performance concerning patients’ unconscious tests will be analyzed using the Plan Formulation Method (Curtis & Silberschatz, 1991). Use of psychodynamic and cognitive-behavioral techniques is rated with the Comparative Psychotherapy Process Scale (Hilsenroth et al, 2015), alliance is rated with the Working Alliance Inventory (Horvath & Greenberg, 1989) by independent observers. Outcome was assessed, amongst others, using BDI, SCL, IIP, and INTREX (see Huber et al., 2012). In a final step, the various process and outcome measures will be correlated in order to provide insight into the link between therapists’ and patients’ interaction and success of therapy.
Results on the differential association between process and outcome across different therapeutic orientations and phases of psychotherapy will contribute to a better understanding of the relation between common and specific therapeutic factors vs patients’ characteristics and patient-therapist interaction.