Elie G. Debbane

Alliance and Technique for Predicting Outcome in Short-and Long-Term Analytic Psychotherapy

A previous clinical trial provided the opportunity to examine the roles and interaction of alliance and technique in both short- and long-term analytic psychotherapy. Two separate teams of trained clinical judges rates either alliance on the CALPAS or therapist interventions on the ITS. Outcome included symptomatology and interpersonal problems. In short-term therapy, working and therapeutic alliance ratings contributed significantly to the reduction of symptomatology only. In long-term therapy, working alliance ratings contributed significantly to the reduction of interpersonal problems, and the interaction of working alliance ratings with supportive or exploratory intervention rating were found to account for significant amounts of the variance of both symptomatology and interpersonal problems at termination. These findings should be considered with caution, given the restricted sample sizes.

The psychoanalytic group situation.

This article explores the theoretical and clinical underpinnings of a specific form of group-centered psychotherapy. In this modality, the nature of the phenomena developing in the clinical situation are related to the prevailing levels of the therapeutic regression occurring in the group. It is suggested that the most regressive phenomena tend to be experienced as groupwide phenomena with individual members assuming the position of part objects, whereas lesser degrees of regression center on the experience of whole-object relations. Five dimensions of the therapeutic situation are explored: regression, the group as a setting, the nature of anxiety, the creation of objects, and symbolization. This model allows for a differentiated exploration of therapist-centered and peer-centered transferences. A session is discussed in detail.