Motivation for brief dynamic psychotherapy.

Abstract

Preliminary research indicates that motivation may be a key predictor of success in brief dynamic psychotherapy, but different aspects of motivation have not been studied as predictors. In this study 48 out-patients were clinically evaluated before therapy with regard to different aspects of motivation. Seven motivation items modified after Sifneos were rated by several experienced judges. Forty-three patients were treated and followed up 2 and 4 years after brief dynamic psychotherapy. The predictive validity of each of the motivation items was tested by their direct correlations with long-term outcome, and their collective predictive validity was tested by use of multiple regression analyses. The interrater reliability was problematic for single items, but when the average scores of 4 judges were used, adequate reliabilities on 4 items were achieved. Two items, Motivation for change and Realistic expectations, showed the best predictive validity of long-term outcome. An Active engagement aspect of motivation may predict both successful and unsuccessful cases. Our data indicate that patients should be instructed about the principles and procedures of dynamic psychotherapy and they should be told why it is important for them to actively test alternative problem-solving strategies during and after therapy.