The Missouri Psychoanalytic Counseling Research Project: Relation of changes in counseling process to client outcomes.

Abstract

A short-term psychoanalytic counseling model was used to identify process dimensions and client outcomes. Six counselors saw 16 clients over the course of 2 semesters. Clients responded to measures at pre- and posttest and after each session, and counselors filled out measures following each session. Sessions were audio- and videotaped and viewed by trained raters. P-technique factor analysis identified 4 dimensions: Psychoanalytic Technique, Working Alliance, Client Resistance, and Client Transference. Results of hierarchical linear modeling indicated that counselor use of psychoanalytic technique and the working alliance increased steadily across the sessions, whereas client resistance steadily decreased. The alliance dimension also changed in a quadratic fashion. The process dimensions also influenced each other and were related to better client outcomes. Implications are discussed and suggestions for future research are provided. The research reported here is about the process and outcomes of time-limited psychoanalytic counseling and is based on a program of theory-driven inquiry derived from the work of Patton and Meara (1992). The need for the study arises from the absence of systematic empirical knowledge about the key elements of the psychoanalytic counseling process, particularly as those are continuously measured over the course of counseling. Given our own understanding of psychoanalyti c counseling as both researchers and practitioners, we were interested in answering the following questions: (a) What are the important dimensions of the psychoanalytic counseling process? (b) What is the nature of changes in these dimensions over time? (c) What are the ways in which these dimensions are related to each other over time? (d) How are changes in these dimensions related to client outcomes? To help us examine these questions we formulated a model to guide our inquiry.