Processing the therapeutic relationship: initial data on the reliability and factor structure of a new clinician-report measure of interpersonal patterns

Psychotherapy has simultaneously been developed with the aim of exploring the processes and outcomes of psychoanalytic psychotherapy in this rare context. This paper will introduce the Melbourne Outcome Study of Psychoanalytic Psychotherapy and consider some recent outcome data from the first wave of patients to complete their two years of therapy at the Clinic. Qualitative data from patient and therapist narrative interviews will enrich the outcome picture and highlight some of the challenges and sensitivities of conducting scientifically-informed research in a psychoanalytic context. Research demonstrated that the clinician's reactions to the patients may have diagnostic and therapeutic relevance and can, if properly used, facilitate rather than inhibit treatment. The present study provides initial data on the reliability and factor structure of a new clinician-report measure of interpersonal patterns designed to assess the client's behaviors with the therapist and the clinician's responses. This measure, called Risk of Conflict Scale (RCS), is based on a cognitive-interpersonal theory, and includes a client's section, to identify how the client appears in the relationship, and a therapist's section, to analyze the countertransference. The measure is based on a Circumplex model, with the two interpersonal dimensions of Dominance and Nurturance; the two-dimensional space was divided into eight equal sectors (octants), and four items were identified that best characterized each octant. The eight octants were labelled, respectively, Love (LOV), Openness (OP), Dominance (DOM), Arrogance (ARR), Hate (HAT), Closure (C), Submission (S), Respect (R). A sample of 168 certified psychologists and psychotherapists completed the Risk of Conflict Scale (RCS) at the end of a session. A group composed of 34 psychothera-pists completed also the Countertransference Questionnaire (CQ). We applied Factor Analysis to identify the factor structure of the Risk of Conflict Scale (RCS). Then we examined the relationship between each of the eight factors and diagnosis of the DSM-IV. The Risk of Conflict Scale (RCS) showed good psycho-metric properties. High correlation between the RSQ factors and the CQ factors indicate the good concur-rent validity of the instrument.