Core Conflictual Relationship Theme Research Articles

Relationships Between God and People in the Bible: A Core Conflictual Relationship Theme Study of the Pentateuch/Torah

The most widely known images of God are from the Bible. An important characteristic of these images is their portrayal of God's interactions with people. Although there have been many religious and literary discussions of God's relationships with people in the Bible, no systematic psychological assessment has been reported. Therefore, the aim of this study was an innovation: to identify patterns of relationship between God and people portrayed in the first five books of the Bible, the Pentateuch or Torah, by using the core conflictual relationship theme (CCRT) method, a widely used scoring system for the assessment of interpersonal relationships. Reliability for the application of the CCRT method to relationship episode narratives in the Pentateuch/Torah was assessed and found to be very good. Results show that the most frequent theme in relationship episode narratives about God and people is that God is helpful. Two less frequent but also highly repetitive themes are that God controls or hurts the other person. Many differences were found between relationship themes defined by the type of person with whom God interacted: patriarch, Moses, woman, non-Israelite, or not a non-Israelite. Thus, the CCRT results identify several different patterns of relationship between God and people.

Consistency in Interpersonal Themes in Narratives About Relationships

The current study investigates the hypothesis that psychiatric patients display consistent interpersonal themes in narratives across different important interpersonal relationships. In response to a revised Relationship Anecdote Paradigm interview, 93 patients with a diagnosable disorder, based on Diagnostic and Statistical Manual of Mental Disorders (third edition, revised) criteria, were asked to give 5 narratives about each of the following significant people in their lives: mother, father, same-sex best friend, and romantic partner. From the transcribed interview material, independent judges reliably rated the intensity of wishes, responses of others, and responses from self associated with a modified Core Conflictual Relationship Theme (CCRT) method (Luborsky & Crits-Christoph, 1990). Consistency of specific relational themes was assessed across multiple interactions with the same person and across different relationships. Although only 1% to 3% of the variance was explained by an individual's consistency, there was substantial variability in specific interpersonal themes across narratives, both across and within relationships (explaining 27% to 30% of the variance). The discussion addresses methodological issues that may have contributed to the current findings and the implications of these findings for the CCRT method, psychodynamic theory and practice in general, and the psychodynamic concept of transference in particular.

The Same Old Song?-Stability and Change in Relationship Schemas From Adolescence to Young Adulthood.

Relationship schemas are core elements of personality that guide interpersonal functioning. The aim of this study is to examine stability and change in relationship schemas across two developmental epochs-adolescence and young adulthood-in the stories that people tell about their interactions with others. Using the Core Conflictual Relationship Theme Method, relationship themes were coded from semistructured interviews conducted in adolescence and again at age 25. The sample consisted of 40 participants in a longitudinal study of adolescent and young adult psychological development. There was considerable stability in the frequency with which particular themes were expressed in the narratives of adolescents and young adults. Significant changes from adolescence to young adulthood included a decrease in the perception of others as rejecting and of the self as opposing others. Young adults saw themselves and others more positively, and used a broader repertoire of themes in their relationship narratives than they had as adolescents. The basic continuity and particular changes in relationship schemas found in this study are consistent with knowledge about the adolescent-to-young-adult transition derived from other empirical and clinical findings. Relationship schemas may be rich units of study for learning about the development of interpersonal functioning.

The Core Conflictual Relationship Theme of Psychotic, Borderline, and Neurotic Personality Organizations

Kernberg's (1984) model of personality describes 3 personality organizations (POs)-psychotic, borderline, and neurotic-each of which has specific characteristics in terms of relationship schemas, defense mechanisms, identity diffusion, and reality testing. The Core Conflictual Relationship Theme (CCRT) method (Luborsky, 1998a) is a measure of central relationship schemas as revealed by relationship narratives. It identifies 3 components: the patient's wishes (Ws), the responses from others (ROs), and the responses of self (RSs). The goals of this study were to compare 2 methods for scoring ROs and RSs and to examine whether different POs vary in terms of their relationship schemas as measured by the CCRT. Eighty-one participants were included in this study. A PO diagnosis was made with the Personality Organization Diagnostic Form (Diguer & Normandin, 1997). Results showed that both scoring methods were equivalent in all dimensions. We found more similarities than differences between the 3 PO groups with respect to Ws, ROs, and RSs. The psychotic PO group presented the flattest CCRT profiles, the least negative responses, and the lowest narrative complexity. These results are discussed in relation to Kernberg's model and the development of the CCRT method.

Comparison between Relationship Patterns in Alopecia areata and in Psychiatric Disorders through the Core Conflictual Relationship Theme (CCRT) Method

Objective: Several reports suggest psychological factors may play a role in the etiology or course of alopecia areata. However, empirical information about the interpersonal patterns of patients with alopecia areata at best is limited. The authors aimed at identifying possible differences between relationship patterns displayed by patients suffering from alopecia areata and those displayed by psychiatric patients. Methods: 36 alopecic patients and 55 psychiatric patients were enrolled in the study. The Core Conflictual Relationship Theme (CCRT) method is a reliable and widely adopted method for scoring relationship patterns, a basic facet of human personality. It was scored on transcriptions of psychotherapy sessions or of interviews dedicated to eliciting material for CCRT scoring, the Relationship Anecdote Paradigm (RAP) interviews. The material was rated according to the Clustered Standard Categories system. The frequencies of each CCRT component in the two samples were confronted through analysis of variance. Results: Patients with alopecia areata showed a higher frequency of the wish: ‘to oppose’, of the responses from others: ‘upset’, ‘reject’, and ‘controlling’, and of the responses of self: ‘oppose’, ‘helpful’, ‘disappointed’ and ‘self-controlled’. The ‘wish’ ‘to assert’ was observed more frequently among the patients with a psychiatric disorder. Conclusion: The present research indicates that patients suffering from alopecia areata display relationship themes different from psychiatric patients.

Maltreatment and Internal Representations of Relationships: Core Relationship Themes in the Narratives of Abused and Neglected Preschoolers

This study examined whether the predominance of particular themes in maltreated pre‐schoolers’ stories about relationships is related to type of maltreatment they experienced. The MacArthur Story Stem Battery was administered to 49 maltreated and 22 non‐maltreated children. Children’s representations of self and other were extracted from the resulting stories using the Core Conflictual Relationship Theme Method. Significant differences were found among the physically abused, sexually abused, neglected, and comparison subgroups with respect to the predominance of specific relationship themes in their stories. Both physically abused and neglected children represented the self as angry and opposing others more frequently than non‐maltreated children. Neglected children represented others as hurt, sad, or anxious more frequently than both abused and non‐maltreated children. Compared with all other children, sexually abused children represented others more frequently as liking them, and compared with physically abused children, expressed more frequent wishes to be close to others. This study supports the hypothesis that maltreated children’s internal representations of relationships are related to their experiences of specific types of maltreatment.

The study on core conflictual relationship of short-term counseling.

This study utilizes the Core Conflictual Relationship Theme Method (CCRT; Luborsky and Crits-Christoph, 1997) on process study of short-term counseling. The purpose was to evaluate the formation and variation of interpersonal conflicts presented by nine clients, so as to enhance the understanding of the core conflicts of each client and how these clients were influenced by short-term counseling. CCRT was conducted by two raters to analyze the content of core conflictual relationship themes. The raters started with taking a twenty-minute vignette from four tapes of the counseling sessions which were the 1st, 2nd, 11th and the 12th. A transcript was taken for each session and the raters searched for relationship episodes (REs) in it. Further, other main persons were identified in REs. Three components, including wish(W), response from others(RO), and response of self(RS) were investigated and analyzed. The raters calculated the appearance frequency of each component and transferred them into formulation of relationship theme in written language. The findings are as follows. (1) The interrater reliabilities between the two raters over W, RO, RS are significant (Kappa = .21-.82, P < .01) (2) The most frequently described other main persons in 201 REs were 'clleague' (N = 87, 43. 3%), the second 'self' (N = 42, 32.8%) and the third 'family members' (N = 41, 20. 4%). The first three described wishes were 'to assert self and be independent' (N = 66, 32.8%), 'to be close and accepted' (N = 48, 23.9%), and 'to be loved and understood' (N = 35, 17.4%) (3) The change of pervasiveness scores of each component in terms of positive and negative responses evaluated by t-test were found to decrease significantly in NRO (r = -2.73, p < .05). The score was most significantly decreased in 'rejecting and opposing' item (t = -3.83, p < .01). Conclusions and suggestions regarding application of the Core Conflictual Relationship Theme analytical and categorization methods in the Chinese context are presented.

Core conflictual relationship themes in patients diagnosed with borderline personality disorder who attempted, or who did not attempt, suicide

Extant relational notions of suicidal behavior were examined in a sample of 22 psychiatric inpatients with a diagnosis of Borderline Personality Disorder (BPD), 11 of whom were hospitalized following a suicide attempt and 11 of whom reported no history of suicidal behavior. Relationship narratives were obtained during a psychodynamically oriented clinical interview and assessed using the Core Conflictual Relationship Theme (CCRT) coding scheme. The results did not support the relational differences of heightened dependency needs, perceived rejection by others, and subsequent anger that were hypothesized to exist between BPD persons who were hospitalized for a suicide attempt and BPD individuals who had never made an attempt. Relational patterns for both groups were similar and consistent with conventional conceptualizations of suicidal behavior and previous CCRT studies examining relational narratives among depressed psychotherapy patients. Specifically, the relational pattern most often described by all participants was a wish to be loved and understood, experiencing others as rejecting, and responding with depression and disappointment.

The core conflictual relationship theme (CCRT) and psychopathology in patients selected for dynamic psychotherapy

The present naturalistic study examined the relation between core interpersonal patterns measured by the Core Conflictual Relationship Theme (CCRT) method and psychopathology in 55 patients selected for long-term dynamic psychotherapy. Psychopathology was assessed by the DSM-III-R, symptom self-report, and the Karolinska Psychodynamic Profile (KAPP). Patients with different DSM-III-R diagnoses did not differ in their CCRTs abstracted from the Relationship Anecdote Paradigm interview. Furthermore, lack of flexibility (pervasiveness) in the use of different CCRT components was not associated with psychiatric symptoms. Only one significant correlation between character pathology and the CCRT was found: problems concerning the patients' experience of social significance were associated with more negative responses of other. Limitations of the CCRT method and the sample used are discussed. Die vorliegende naturalistische Studie prüfte den Zusammenhang zwischen interpesonalen Mustern - gemessen mit der ZBKT-Methode - und der Psychopathologie bei 55 Patienten, die für eine psychodynamische Langzeittherapie indiziert waren. Psychopathologie wurde mit dem DSM-III-R, Selbstbeschreibungen und dem Karolinska Psychodynamic Profile (KAPP) untersucht. Patienten mit verschiedenen DSM-III-R Diagnosen unterschieden sich nicht im Hinblick auf ihre ZBKT in einem Beziehungsinterview. Mangel an Flexibiltät bezüglich unterschiedlicher ZBKT-Komponenten stand nicht in Beziehung zu psychiatrischen Symptomen. Nur eine signifikante Korrelation zwischen Charakterpathologie und ZBKT lie ß sich nachweisen: Probleme der Patienten mit ihrer sozialen bedeutung standen in Beziehung zu negativeren Reaktionen von Objekten. Bergrenzungen der ZBKT-Methode und der Stichprobe werden diskutiert. Cette étude naturaliste examine la relation entre des patterns interpersonnels de base mesurés par la méthode du Thème Relationnel Conflictuel Central (CCRT) et la psychopathologie chez 55 patients sélectionnés pour une psychothérapie psychodynamique de longue durée. La psychopathologie a été évaluée selon DSM-III-R, par un auto-questionnaire de symptômes et par le Karolinska Profile Psychodynamique (KAPP). Les patients avec des diagnostics DSM-II-R différents n'ont pas montré de différence dans leur CCRT obtenu sur la base d'interviews RAP (Paradigme d'Anecdotes Relationnelles). Par ailleurs, le manque de flexibilité ('pervasiveness') dans l'emploi des différentes composantes du CCRT n'a pas été associé à des symptômes psychiatriques. Une seule corrélation significative entre pathologie de catarctèe et CCRT aété trouvée; une expérience de position sociale problématique a été associée à des réponses de l'autre plus négatives. Nous discutons des limitations de la méhode du CCRT et de l'échantillon. El presente estudio naturalístico examina la relación entre el núleo de pautas interpersonales medida por el método del Tema Nuclear Relacional Conflictivo (CCRT) y la psicopatología en cincuenta y cinco pacientes seleccionados para psicoterapia dinámica a largo plazo. La psicopatología se evaluó según el DSM-III-R, el informe auto-administrado de sintomas y el Perfil Psicodinámico de Karolinska (KAPP). Pacientes con diferentes diagnósticos según el DSM-III-R no difirieron en el CCRT abstraído de la entrevista Paradigma Anecdótico Relacional (Relationship Anecdote Paradigm). Más aun, la falta de flexibilidad ['pregnancia' ('pervasiveness')] en el uso de diferentes components del CCRT no estuvo asociada con síntomas psiquiátricos. Solo se encontró una correlación significativa entre la caracteropatía y el CCRT; los probelmas relacionados con la experiencia de significatividad social de los pacientes estuvo asociada con respuestas más negativas del otro. Se discuten las limitaciones del método del CCRT y de la muestra usada.

The principles and methods of objective psychotherapy

Originally published in JCLP, 5, 193–201 (1949) © 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 877–887, 2000.

A current reader's response to the article of 50 years ago by Karpman, B. (1949): “The principles and methods of objective psychotherapy”

The first aim is to describe the psychotherapy of 1949 in the light of today's psychotherapies. The old psychotherapy is suited to treating severely ill patients. It does not use free association, but rather is focused on current problems. It uses dreams, yet it also uses homework and bibliotherapy. The second aim is to critique the treatment. Consistent with its era. it does not make use of medications, and there is an absence of references to psychotherapy research, which was then just starting. The treatment relies over-heavily on the authority of the therapist. A third aim is to describe the changes in our field in the past 50 years and examine the predictions for the future. Although the treatment is called objective psychotherapy, it does not make use of the most up-to-date means of measuring accuracy of interpretations, such as the Core Conflictual Relationship Theme (CCRT) method and other methods like it.

A pattern-setting therapeutic alliance study revisited

The editors of Psychotherapy Research had invited me to review my now-classic 1976 paper on the alliance and to include these topics: what that paper was about and the impact it has had on my own and other peoples' research. This paper has provided that. A brief summary follows of what the 1976 paper was about: it contained the first report of the two new session-based alliance measures, the HAcs and the HAr. It also contained the first report of the central relationship pattern measure, the Core Conflictual Relationship Theme (CCRT). A brief summary also follows of what the 1976 paper led to: (a) a similarly composed trio of alliance measures, including the HAcs, the HAr, and the HAq-I (this has since been expanded to become the HAq-II); (b) the discovery of moderately high to high inter-correlations among the Penn alliance measures and other main alliance measures in the field (Tichenor & Hill, 1989; Tang & DeRubeis, in press; and Hatcher & Barends, 1996); and considerable expansion of information about the positive predictive capacities of these and other alliance measures for the outcomes of psychotherapy. Die Herausgeber der Zeitschrift haben mich dazu eingeladen, unsere mittlerweile klassiche Arbeit über die therapeutische Allianz aus dem Jahr 1976 zu kommentieren und folgende Themen zu behandeln: Worum ging es in dieser damaligen Arbeit und welche Auswirkungen hatte der Inhalt auf meine eigene Forshcung und die anderer. In diesem Beitrag wird dies zusammengefaßt. Die damalige Arbeit war der erste Bericht über zwei neue Maße der theapeutischen Allianz, die sich auf einzelne Therapiesitzungen bezogen, die HAcs und die HAr. In dem Artikel wurde auch erstmalig über das Maß zentraler Beziehungsmuster, das zentrale Beziehungskonfliktthema (ZBKT) berichtet. Im folgenden wird zusammengefaßt, was aus der Veröffentlichung resultierte: a) ein ähnlich komponiertes Trio von Allianzmaßen, bestehend aus der HAcs, der HAr und dem HAq-I (jetzt ausgeweitet als HAq-II), b) die Entdeckung mittelhoher Korrelationen zwischen den Allianzmaßen in diesem Feld (z. B. jene von Tichenor und Hill, 1989, Tang und DeRubeis in Druck, Hatcher und Barends, 1996); c) eine beträchtliche Ausweitung des Wissens über die positive prädiktiven Möglichkeiten dieser und anderer Allianzmaße für das Ergebnis von Psychotherapien. Les éditeurs de Psychotherapy Research m'avaient invité à reprendre l'article de 1976, entretemps devenu un classique, sur l'alliance, et d'y inclure les sujets suivants: l'essence de cet article, et l'impact qu'il a eu sur ma propre recherche et celle d'autres chercheurs. C'est ce que cet article offre effectivement; il résume briévement le sujet, à savoir, la premiére communication sur les deux nouvelles mesures de l'alliance d'une séance. la HAcs et le HAr. En outre, il contient la première mention de la mesure du pattern relationnel cnetral, le Théme Relationnel Conflictuel Central (CCRT). Un bref résumé décrit les conséquences que cet article de 1976 a eues: (a) un trio de mesures de l'alliance, composé de façon semblable, et incluant le HAcs, le HAr, et le HAq-I (qui a depuis évolué vers le HAq-II); b) le constat d'intercorrélations moyennement hautes entre les mesures de l'alliance de Penn et d'autre mesures de l'alliance dans ce domaine (Tichenor and Hill, 1989; Tand and De Rubeis, in press; and Hatcher and Barends, 1996); et c) une expansion considérable en information au sujet des capacités prédictives des résultats de psychothérapies de ces mesures de l'alliance et d'autres. Una investigación clásica. Los editores de Psychotherapy Research me invitaron a revisar mi ya clásico trabajo de 1976 sobre la alianza terapéutica, en el que debía incluir; el tópico de aquel trabajo y su influencia sobre mis investigaciones y las de otros investigadores. El trabajo proporciona: un breve resumen del tema y el primer informe de dos nuevas medidas de la alianza terapéutica basadas en la sesión, el HAcs y el Har. También contenía el primer informe de la medida de la pauta central relacional, el Tema Nuclear Relacional Conflictivo (Core Conflictual Relationship Theme, CCRT). Este artículo contiene, además, un breve resumen de lo logrado por el trabajo de 1976: a) un trio de medidas de alianza compuesto en forma similar, el HAcs, el Hr, y el Haq-I (este se ha ampliado desde entonces para ilegar a ser el Haq-II; b) el hallazgo de intercorrelaciones de intercorrelaciones moderadamente altas entre las medidas de alianza Penn y otras medidas principales en nuestro campo (Tichenor y Hill, 1989), Tang y DeRubeis (en prensa), y Hatcher y Barends (1996); y.c.) con

How to Practice Brief Psychodynamic Psychotherapy: The Core Conflictual Relationship Theme Method

Back to table of contents Previous article Next article Book ReviewFull AccessHow to Practice Brief Psychodynamic Psychotherapy: The Core Conflictual Relationship Theme MethodRobert Andre Kimmich, M.D.Robert Andre KimmichSearch for more papers by this author, M.D.Published Online:1 Aug 1999https://doi.org/10.1176/ps.50.8.1095AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This slim volume should be read by every professional who practices psychotherapy. The importance of the work lies in its intimate style and inside view of the psychotherapeutic dyad. One feels as if in the presence of a wise and skilled psychiatrist who is talking about his work to a fellow colleague, the reader. Dr. Book does not preach or harangue, but elucidates the therapeutic interchange. Although the author calls his book a manual, its strength lies in his clarification of why treatment in his hands proceeds the way it does.Dr. Book is an associate professor of psychiatry at the University of Toronto Faculty of Medicine and is also in private practice. He has specialized in developing and teaching brief psychodynamic psychotherapy. His text is intended as a practical, step-by-step manual for teaching therapists of various disciplines the core conflictual relationship theme (CCRT) method of brief psychotherapy developed by Lester Luborsky, Ph.D., and others.The introductory chapter consists of 18 pages of an outstanding summary of principles of psychodynamic psychotherapy. It can apply to any school of dynamic therapy. It takes an expert to boil down so much important material into a readable and concise form. Readers should not skip this section.The CCRT method is set forth in detail in part 1. The author states the goals as follows: "Brief psychodynamic psychotherapy has as its goals symptom relief and limited, though significant, character change attained through a finite number of sessions." He goes on to say, "As with all dynamic psychotherapies, including long-term psychotherapy and psychoanalysis, the practice of brief psychodynamic psychotherapy requires the therapist to blend expressive and supportive activities."Dr. Book explains that patients need to be suited to the method, with adequate ego strength and verbal ability, and must able to work within the weekly, 16-session format specified for CCRT. The 16-session limit is not carved in granite but provides the chronological and technical context. The author discusses when and how to deviate from the time limit.A major component of the method is to choose one specific, important, repetitive conflictual relationship problem on which to focus treatment. The therapist conceptualizes this problem after a thorough evaluation and formulation.Part 1 also deals with developing the focus of the CCRT, or the theme of the brief psychodynamic therapy. Even though the details are common sense to an experienced therapist, it is fascinating to follow Dr. Book's treatment examples as they unfold. They are complete with commentary, including discussion of transference and countertransference and repetition compulsion. I was a little put off by the codification of conflict components—for instance, RO for response from the other, RE for relationship episode, W for wish, and RS for response from the staff—but one catches on. The ideas are quite useful.Part 2 is the engaging verbatim transcription of a course of therapy with one of the author's patients. Dr. Book treats us to his own running commentary to the transcription, in an engrossing discussion of the technical hows and whys. It is hard to put this excellent book down.How to Practice Brief Psychodynamic Psychotherapy will be interesting reading for the trained and accomplished psychotherapist, but also of great value to the advanced trainee who has some basic knowledge of psychodynamic concepts. Another audience for this fine exposition would be psychiatric residency training directors or other advanced professionals in psychotherapy training programs.Dr. Book does a masterful job of meeting the objectives of this work and certainly demonstrates his own skill in the process. Useful references are also supplied. Even though he sets out to provide a manual on brief psychodynamic psychotherapy, he succeeds more broadly in emphasizing skills needed for psychotherapy of any duration.Dr. Kimmich is in the private practice of psychiatry in San Francisco and is a member of the American Psychiatric Association's commission on psychotherapy by psychiatrists.by Howard E. Book, M.D., D.Psych.; Washington, D.C., American Psychological Association, 1998, 181 pages, $39.95 FiguresReferencesCited byDetailsCited ByNone Volume 50Issue 8 August 1999Pages 1095-1096 Metrics History Published online 1 August 1999 Published in print 1 August 1999

How to Practice Brief Dynamic Psychotherapy: The Core Conflictual Relationship Theme Method

HOWARD E. BOOK, M.D., D.PSYCH.: How to Practice Brief Dynamic Psychotherapy: Conflictual Relationship Method. American Psychological Association, Washington, DC, 1997, 181 pp., $39.95, ISBN 1-55798-46-54. Dr. Book is psychoanalytically oriented. Seeing the increasing demands for psychotherapy from clients and for cost containment from third-party payers, he turned to investigating the brief psychodynamic psychotherapies and adopted the wellknown time-limited approach developed by Luborsky, identified as The Conflictual Relationship Method, that seems to bring not only symptom relief but some significant characterological change as well. This work by Book serves as fine introduction to this mode of doing brief psychotherapy, as Luborsky himself recognizes in the Foreword. Book helped establish Brief Psychodynamic Psychotherapy Training Program at the University of Toronto. He is Coordinator of Brief Psychotherapy Training for psychiatry residents and Director of the Post-Graduate Training Program in brief psychodynamic psychotherapy at the Clarke Institute of Psychiatry in Toronto. He has private practice where he does brief and long-term psychotherapy and supervises therapists. His dedication and skill as teacher are evident in his structuring of this book, which he correctly describes as a user-friendly, readable, clinically focused presentation of this method. In an Introduction and Part I, he uses clinical vignettes to sketch out the strengths and weaknesses of brief approaches, the inclusion and exclusion criteria for the selection of suitable patients, the particular countertransference issues that emerge, and the use of supportive and expressive techniques derived from all dynamic therapies that are applied in particular blend tailored to this mode of treatment. Following Luborsky, he demonstrates techniques that help guide patients into portraying their symptoms and distress within the context of specific interactions or relationship they have had with others. He demonstrates how therapists can scan for overarching within these episodes and then bundle them together, while using an experience near attentiveness rather than psychodynamic oriented one, to discover that the themes often share fundamental Core Conflictual Relationship Theme that defines precisely the circumscribed area of maladaptive interpersonal functioning that is most problematic for each patient and on which then the time-limited therapy can most fruitfully focus. Part II is detailed case study of Book's evaluation, 16 treatment visits, and follow-up interview of woman client who had severe problems by being excessively compliant. He provides essential details of the client's and of his own communications. He comments on why he said what he said and how he concludes that what he said was successful or not. Laying himself out quite openly, he demonstrates his confidence and enthusiasm for this method and in the success of this particular treatment course. And indeed the patient felt she had been helped. psychoanalytic ear of some readers may find that things are overall bit too pat and wrapped up so neatly that the full range of complex processes embedded within the interactions between him and his client are not fully captured. Shortcuts can be treacherous. Yet, this material is instructive just because of this. For the work demands of each reader to probe on his or her own for what is really going on between these two. For example Book proposed the time-limited therapy contract in dialogue that went as follows (pp. …

Stereotypical Relationship Patterns and Psychopathology

Background: We explored the relationship between the consistency of relationship patterns and the severity of psychopathology. Method: Relationship patterns were assessed by means of Relationship Anecdote Paradigm interviews rated according to the Core Conflictual Relationship Theme (CCRT) method. The repetition of the same type of CCRT components across relationship narratives indicated stereotypical patterns. Results: Subjects treated in an inpatient setting (n = 25) told narratives with more consistent patterns than subjects in an outpatient setting (n = 32). Relationship episodes of normal adults (n = 23) were more flexible compared with the two clinical groups. Especially repetitions of the wish component were closely associated with the severity of psychopathology assessed by SCL-90R. Conclusions: The consistency of relationship patterns seems to be connected with the severity of psychopathology.

The Connected Central Relationship Patterns (CCRP): A Structural Version of the CCRT

The Core Conflictual Relationship Theme (CCRT) developed by Luborsky is a content-analytic method for the measurement of repetitive relationship patterns. Narratives about relationship episodes with the self and with significant others serve as a data base. The most frequent of three judged components (wish, response from others, response of self) to be rated constitute the CCRT. In this paper we present a further methodological development of the CCRT, a structural version we have named Connected Central Relationship Patterns (CCRP). It is a method of identifying “macro-molecular” relationship structures. We describe the approach, the specific features of data acquisition, the statistical analysis which was based on further development of methods for contingency tables and some applications. A psychodynamic short-term therapy with almost 300 relationship episodes serves as an example. Das zentral Beziehungskonfliktthema (ZBKT), entwickelt von Luborsky, ist eineinhaltsanalytische Methode zur Erfassung sich wiederholender Beziehungs muster. Narrative über Beziehungsepisoden mit der eigenen person und mit bedeutsamen Andern stellen die Ausgangsbasis für die Methode dar. Die am häufigsten vorkommenden drei Komponenten (Wunsch, Reaktionen anderer, Reaktionen des Selbst), welche in den Beziehungsepisoden signiert werden, konstituieren das zentrale Beziehugskonfliktthema. In dieser Arbeit Wire eine methodische Weiterentwicklung des ZBKT, eine strukturelle Version, die wir als verbundenezentrale Beziehungsmuster bezeichnet haben, ausführlicher dargestellt. Es handeltsichhierbei um eine Methode zur identifikation „ Makro-molekularer ” Beziehungsstrukturen. Wir beschreiben den Ansatz, spezifizche Details im Hinblick auf die Datensammulung, statistische Prozeduren, die sich im wesentlichen auf Weiterentwicklungen von methoden zur Analyse von Kontingenztafeln stützen sowie einige Anwendungen. Eine Psychodynamische Kurzzeittherapie, in deren Rahmen beinahe dreihundert Beziehungsepisoden signiert wurden, dient als ausführliches Beispiel. Le Thème Relationnel Conflictuel central (CCRT) développé par Luborsky est une méthode d'analyse de contenu conçue pour quantifier des patterns relationnels répétitifs. Des narrations d'épisodes relationels concernant soi-même et les autres significatifs servent de base de données. Les plus fréquentes de chacune des trois composantes cotées (désir, réponse des autres, réponse du sujet) constituent le CCRT. Dans cet article nous présentons un développement méthodologique du CCRT, une version structurale que nous appelons les patterns Relationnels Centraux Connectés (CCRP). Il s'agit d'une méthode pour indentifier des structures relationnelles «Macro-moléculaires». Nour décrivons l'approche, la manière spécifique de récolter les données, l'analyse statistique basée sur le développement de méthodes pour des tableaux de contingence, et quelques applications. Une Psychothérapie dynamique brève comprenant presque 300 épisodes relationnels ser d'exemple. El núcleo temático de la relación conflictual (CCRT) desarrollado por Luborsky es un método de análisis de contenido para la medición de pautas repetitivas de relación. Le sirven be base de datos las narrativas acerca de episodios relacionales con otros personajes significativos. Los más frecuentes de los tres componentes (deseo, respuesta de los otros, respuesta del self) a ser computados constituyen el CCRT. En este trabajo presentamos un desarrollo metodológico nuevo del CCRT, una versión estructural que hemos llamado Pautas relacionales Centralmente Conectadas (CCRP). Es un método de indentificación „; macromolecular ”; de estructuras relacionales. Describimos el enfoque, los rasgos específicos de la recolección de datos, el análisis estadístico basado endesarrollos posteriores de métodos para tablas de contingencial, así también como algunas aplicaciones. Como ejemplo, se presenta una terapia psicodinámica de corto plazo con unos 300 episodios relacionales.

The Accuracy of Reformulation in Cognitive Analytic Therapy: A Validation Study

The Self States Sequential Diagram (SSSD) is a tool developed by Ryle (Ryle, 1990, Beard, Marlowe & Ryle, 1990) as part of the technique of reformulation in cognitive analytic therapy. Patient and therapist collaborate to describe the patient's problematic patterns of relating to others and the self and use the resulting diagram to aid recognition and revision of these patterns in the patient's everyday life and within the therapeutic relationship. We report on the accuracy of this diagrammatic description by validating one patient's SSSD using the Core Conflictual Relationship Theme Method (CCRT; Luborsky & Crits-Christoph 1990) and Structural Analysis of Social Behaviour-Cyclic Maladaptive Pattern (SASB-CMP; Benjamin, 1974, 1987; Benjamin, Foster, Roberto & Estroff, 1986; Schacht & Henry, 1994). This comparison supports the view that it is possible for the therapist to create a descriptive diagram which is a valid representation of recurrent relationship patterns. Das sequentielle Diagramm der Selbstzustände ist ein Instrument, welches von Ryle (Ryle 1990; Beard, Marlowe & Ryle 1990) als Teil der Reformulierungstechnik in der Kognitiv-Analytischen Therapie entwickel wurde. Patient und Therapeut versuchen dabei gemeinsam, die für den Patienten problematischen Beziehungsmuster (zu anderen und zu sich selbst) zu beschreiben und verwenden das daraus resultierende Diagramm, um diese Muster im Alltag des Patienten und in der therapeutischen Benziehung zu erkennen und zu verändern.Wir berichten über die Genauigkeit dieser Beschreibung, indem wir das Diagramm eines Patienten mit Hilfe der ZBKT-Methode (Luborsky & Crits-Christoph 1990) sowie der strukturalen Analyse sozialen Verhaltens bzw. des zyklisch maladaptiven Muster (SASB-CMP; Benjamin, Foster, Roberto & Estroff 1986; Schacht & Henry 1994) validieren. Der Vergleich legt nahe, dass es für den Therapeuten tatsächlich möglich ist, ein Diagramm zu entwickeln, das immer widerkehrende Beziehungsmuster valide beschreibt. Le Diagramme SeAquentiel des Etats du Soi (SSSD) a été développé par Ryle (Ryle, 1990) comme un élément de la technique de reformulation en thérapie cognitive-analytique. Patient et thérapeute collaborent pour décrire les patterns problématiques du patient dans les relations avec les autres et soi-même, et ils se servent du diagramme qui s'en dégage pour aider à la prise de connaissance ainsi qu'au changement de ces patterns dans la vie de tous les jours comme dans la relation thérapeutique. Nous signalons la justesse de cette description en diagramme qui été validé par rapport au Théme Relationnel Conflictuel Central (CCRT; Luborsky & Crits-Christoph 1990) et à l'Analyse Structurale du Comportement Social - Pattern Cyclique Maladapté (SASB-CMP; Benjamin, 1974, 1987; Benjamin, Foster, Roberto & Estroff, 1986; Schacht & Henry, 1994). Cette comparason vient à l'appui de l'idée qu'il est possible au thérapeute de créer un diagramme descriptif qui est une représentation valide de patterns relationnels répétitifs. El Diagrama Secuencial de Estados del Self (Self states Sequential Diagram, SSSID) es un instrumento desarrollado por Ryle (Ryle, 1990, Beard, Marlowe & Ryle, 1990) como parte de lat técnical de reformulación en terapia analítica-cognitiva. El paciente y el terapeuta colaboran para describir las pautas de los patrones probleméticos de relación del paciente con otros y consigo mismo y para usar el diagrama resultante para el reconocimiento y la revisión de estos patrones en la vida cotidiana del paciente y dentro de la relación terapéutica. Informamos sobre la exacttud de esta descripción diagramética por medio de la validación del SSSD de un paciente usando el Core Conflictual Relationship Theme Method (Método del Tema Nuclear conflictivo en las relaciones (CCRT; Luborsky & Crits-Christoph 1990) y el Structural Analysis of Social Behaviour-Cyclic Maladaptive Pattern (Anélisis estructural del patrón de comportamiento social maladaptativo cíclico) (SASB-CMP; Benjamin, 1974, 1987; Benjamin, Foster, Roberto & Estroff, 1986; Schacht & Henry, 1994). Esta comparación apoya la creencia de que el terapeuta puede crear un diagrama descriptivo como representación vélida de patrones relacionales recurrentes.

The accuracy of reformulation in cognitive analytic therapy: a validation study

The Self States Sequential Diagram (SSSD) is a tool developed by Ryle (Ryle, 1990, Beard, Marlowe & Ryle, 1990) as part of the technique of reformulation in cognitive analytic therapy. Patient and therapist collaborate to describe the patient's problematic patterns of relating to others and the self and use the resulting diagram to aid recognition and revision of these patterns in the patient's everyday life and within the therapeutic relationship. We report on the accuracy of this diagrammatic description by validating one patient's SSSD using the Core Conflictual Relationship Theme Method (CCRT; Luborsky & Crits-Christoph 1990) and Structural Analysis of Social Behaviour-Cyclic Maladaptive Pattern (SASB-CMP; Benjamin, 1974, 1987; Benjamin, Foster, Roberto & Estroff, 1986; Schacht & Henry, 1994). This comparison supports the view that it is possible for the therapist to create a descriptive diagram which is a valid representation of recurrent relationship patterns. Das sequentielle Diagramm der Selbstzus...

The Central Relationship Questionnaire: Initial report.

This study presents an initial evaluation of the psychometric properties of the Central Relationship Questionnaire (CRQ), a measure of central relationship patterns. These patterns refer to people's characteristic ways of relating to significant others in terms of their wishes, their perceptions of others' responses to them, and their own responses to both of these. The self-report CRQ is derived from L. Luborsky's (1977) clinician-rated Core Conflictual Relationship Theme. Overall, the results indicated that the CRQ components could be differentiated into meaningful subscales. These subscales were internally consistent, demonstrated significant stability over a year, and evidenced preliminary convergent and divergent validity with measures of interpersonal problems and symptomatology. It is concluded on the basis of these promising results that the CRQ merits further empirical development. Specific suggestions for accomplishing this are presented. Central interpersonal patterns refer to characteristic ways of relating to others and are thought to be the product of highly ingrained patterns or schemas of relationships with important others. These relational patterns are presumed to be initially constructed from emotionally laden interactions with parental figures in the earliest years of life that are then carried forward into subsequent relationships. According to psychodynamic theory, the patterns are compromise formations (Brenner, 1982) of conflicts between incompatible wishes (impulses) or between unacceptable wishes and prohibitions. A primary aim of dynamic psychotherapy is to address maladaptive interpersonal patterns across the client's different relationships as a means of achieving insight and eliciting therapeutic change (e.g., Davanloo, 1980; Luborsky, 1984; Malan, 1976a, 1976b; Strupp & Binder, 1984). The clinical utility of theory-driven measures of central relationship patterns has long been recognized by researchers as a central component of dynamic formulation, as an important focus of interpretatio ns, and as a theoretically relevant measure of outcome and change. Although early attempts to assess these theoretical constructs failed to

The use of the Core Conflictual Relationship Theme method in describing and comparing gestalt and rational emotive behavior therapy with adolescents

The Core Conflitual Relationship Theme (CCRT) method (Luborsky, 1977) is used to study recurrent relationship patterns in therapy and may be employed as a measure of transference as well. We found only one article in the literature in which it was applied to a mode of psychotherapy, other than psychodynamic (Turner, 1992). In addition, there are only a few articles in the literature that refer to the CCRT method with children and adolescents. In this paper, we applied the CCRT method to two videotaped individual sessions of young adolescent boys, one in gestalt therapy and the other in rational emotive behavior therapy. Results showed that both boys revealed similar core relational theme profiles, but that their respective therapists each dealt differently with these relationship conflicts. In this pilot use of the CCRT with adolescent therapy, we were able to describe relationship patterns and delineate key differences between the two treatment modalities.