The relationship of dependency and self-criticism to alliance, complementarity and outcome in short-term dynamic psychotherapy

Naomi Anne Ferleger, Fordham University


Psychotherapy research has been moving towards the study of patient pre-treatment characteristics in interaction with process and outcome. This study aimed to examine formulations of dependency and self-criticism (Blatt, 1974) as they relate to alliance, complementarity and outcome in short-term dynamic psychotherapy. We predicted that alliance, complementarity and outcome would differ for the groups. We further expected the relationship of alliance and complementarity to outcome to discriminate between dependents and self-criticism. This study involved 40 outpatients and 20 therapists participating in a 40-session dynamic psychotherapy. Patients provided pre- and post-treatment evaluations on the Symptom Checklist 90-R (SCL-90-R), Social Adjustment Scale - Self-Report (SAS-SR) and Target Complaints (TC). Patients were rated by one pair of independent raters on the Dependency/Self-criticism Rating Manual. Nine other rating teams used the California Psychotherapy Alliance Scales - 12 (CALPAS-12) and Interpersonal Adjectives Scale - 16 (IAS-16) to rate the 40 therapeutic dyads. Ratings were completed on early videotaped therapy sessions. Means and standard deviations for all process and outcome variables were computed separately for the two groups. Data were analyzed using ANOVAS, a MANOVA and MANCOVA, and correlational analyses. No significant findings emerged with respect to alliance, complementarity or outcome. Alliance and complementarity were differentially related to outcome within each group. Among self-criticals, a moderately strong alliance and greater matching of patient-therapist affiliative behaviors were associated with better treatment outcome. Among dependents, greater opposition of patients' and therapists' dominant-submissive behaviors was related to patients' improved interpersonal functioning. Higher complementarity on affiliative behaviors was linked to better interpersonal functioning for self-critical versus dependent patients; however, this may have been a chance finding. Explanations of our findings were considered with respect to theoretical and methodological issues. Future directions for research were proposed.

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Recommended Citation

Ferleger, Naomi Anne, "The relationship of dependency and self-criticism to alliance, complementarity and outcome in short-term dynamic psychotherapy" (1993). ETD Collection for Fordham University. AAI9324614.