Patient personality dimensions, relational patterns and therapeutic alliance in clinical practice: An empirical investigation.
PRQ
SWAP-200
clinician-patient relational patterns
personality traits
psychotherapy
therapeutic alliance
Journal
Clinical psychology & psychotherapy
ISSN: 1099-0879
Titre abrégé: Clin Psychol Psychother
Pays: England
ID NLM: 9416196
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
revised:
03
07
2022
received:
10
04
2022
accepted:
15
08
2022
pubmed:
19
8
2022
medline:
3
2
2023
entrez:
18
8
2022
Statut:
ppublish
Résumé
Transference (meant in this context, as the patient relational patterns expressed towards the clinician) and therapeutic alliance play a crucial role in the treatment of personality pathology. To date, no empirical study examined the association between these two dimensions of the clinical relationship and patients' personality maladaptive traits in psychotherapy. A national sample of therapists (N = 100) of different theoretical orientations assessed dysfunctional personality features of a patient in their care using a comprehensive and empirically grounded dimensional diagnostic approach from the Shedler-Westen Assessment Procedure-200 (SWAP-200). Moreover, they filled in the Psychotherapy Relationship Questionnaire (PRQ) to identify interpersonal patterns expressed early in treatment by the patients and the Working Alliance Inventory (WAI-T) to evaluate quality of therapeutic alliance. Overall, the most severe and maladaptive dimensions of patients' personality were associated with more negative clinician-patient dynamics and poorer levels of therapeutic alliance in statistically significant and clinically relevant ways. Notably, the hostile transference was predicted by both SWAP Hostility and Psychopathy, whereas the SWAP Narcissism was the strongest predictor of the special/entitled transference. The latter was also predicted by SWAP Emotional Dysregulation; conversely, the SWAP Dysphoria was the most robust predictor of anxious/preoccupied pattern. The SWAP Schizoid Orientation and Psychopathy predicted avoidant/dismissing attachment pattern; moreover, they were strongly and negatively related to the SWAP Psychological Health that was the best predictor of positive transference and alliance. Findings support that therapists' careful understanding of patients' interpersonal ways during early treatment stages may meaningfully inform diagnostic and therapeutic processes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
97-111Subventions
Organisme : Scientific Committee of the Psychodynamic Diagnostic Manual, Second Edition (PDM-2) and the Interdisciplinary Council on Developmental and Learning Disorders
Informations de copyright
© 2022 John Wiley & Sons Ltd.
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