One step further in assessing how interpretations influence the process of psychotherapy

Abstract

The question of how interpretations take effect is among the most important in psychotherapy research. In a landmark study, Silberschatz, Fretter, and Curtis (1986) developed a method to assess the compatibility between an interpretation and a patient's psychology (the patient's unconscious plan), and demonstrated that this factor-plan compatibility-may contribute substantially to an interpretation's effect. However, they did not consider the following possibility: An interpretation might be plan compatible in terms of content, but incompatible in terms of process (e.g., an interpretation accurately identifying a patient's fear of acting independently may be delivered in a controlling way), or vice-versa. In a reanalysis of data provided by Silberschatz et al. (1986), we demonstrate that raters can reliably distinguish content from process in evaluating plan compatibility. We demonstrate, further, that a distinction between content and process plan compatibility may increase the amount of explained variance in Patient Experiencing scores. Of particular interest is an analysis of interpretations in which the aspects of plan compatibility (content or process) differed, which showed that the aspect of plan compatibility most highly correlated with Experiencing varied across the cases. This finding suggests that attention to the distinct contributions of content and process to plan compatibility may help further our understanding of how individual patients listen to and utilize therapist interventions.