Quality of object relations versus interpersonal functioning as predictors of therapeutic alliance and psychotherapy outcome

Article Abstract:

The importance of the relationship between therapist and patient for the outcome of treatment is generally not disputed and it is widely held that the quality of relationships with past important figures is one way to predict how good a working relationship a patient is likely to form with a therapist. It stands to reason, then, that the quality of a patient's pretherapy relationships will be predictive of therapeutic outcome. Research, however, has not consistently found this to be true. It is possible that outcome can be predicted from the quality of object relations (a developmental stage of the self-concept) demonstrated by the patient. This was tested using the Quality of Object Relations Scale (QORS), a measure of the lifelong pattern of interpersonal relationships, to evaluate 64 patients in a walk-in clinic prior to short-term, time-limited individual psychotherapy. The patient and the therapist independently provided ratings of therapeutic alliance (an evaluation of their working relationship) after each session and outcome measures were provided by the patient, therapist, and an independent assessor. Outcome measures covered areas of interpersonal functioning, self-esteem, life satisfaction, and psychiatric symptom (e.g., depression) resolution. The QORS was administered prior to the beginning of therapy. Results showed that the quality of object relations was the best predictor of therapeutic outcome; positive QOR scores were correlated with stronger alliances. The patient- and therapist-rated alliances and outcomes were significantly related to the QORS score. The data replicate previous findings of a significant relationship between the patient-therapist alliance and therapeutic outcome, and show that a comprehensive, lifelong measure of interpersonal functioning is a better predictor of therapeutic alliance and outcome than measures of recent interpersonal relationships. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Evaluation, Interpersonal relations, Therapist and patient, Therapist-patient relations, Object relations (Psychoanalysis), Object attachment

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Prognostic significance of cerebral status: dimensions of clinical outcome

Article Abstract:

The long-term outcome of schizophrenia is generally assumed to be poor. However, outcomes do vary, so researchers have looked for valid predictors. Some useful predictors include illness onset (rapid versus slow), family history of psychiatric illness, and sociodemographic functioning prior to illness. With the identification of brain abnormalities associated with mental illness, there is now a search for neurobehavioral predictors of outcome in schizophrenia. Social and work functioning, and rehospitalization were assessed for 51 psychiatric patients an average of 23.5 months after discharge from the hospital. While hospitalized, these patients had neuropsychological testing that included assessment of cognitive and perceptual abilities, sensorimotor function, and skill at complex information processing tasks. Work performance since discharge was more related to the neuropsychological data than to measures of social functioning or rehospitalization. Cerebral dysfunction (perceptual and cognitive difficulties) before the onset of mental illness are important considerations in the prognosis and long-term outcome of severe mental illness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Testing, Physiological aspects, Prognosis, Demographic aspects, Mental illness, Mental disorders, Cognition, Perception, Perception (Psychology), Outcome and process assessment (Health Care), Outcome and process assessment (Medical care), Luria-Nebraska Neuropsychological Battery

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