A1 Journal article (refereed)
Predicting the working alliance over the course of long-term psychodynamic psychotherapy with the Rorschach Ego Impairment Index, self-reported defense style, and performance-based intelligence : An evaluation of three methodological approaches (2021)

Stenius, J., Knekt, P., Heinonen, E., Holma, J., Antikainen, R., & Lindfors, O. (2021). Predicting the working alliance over the course of long-term psychodynamic psychotherapy with the Rorschach Ego Impairment Index, self-reported defense style, and performance-based intelligence : An evaluation of three methodological approaches. Psychoanalytic Psychology, 38(1), 58-67. https://doi.org/10.1037/pap0000318

JYU authors or editors

Publication details

All authors or editors: Stenius, Jaakko; Knekt, Paul; Heinonen, Erkki; Holma, Juha; Antikainen, Risto; Lindfors, Olavi

Journal or series: Psychoanalytic Psychology

ISSN: 0736-9735

eISSN: 1939-1331

Publication year: 2021

Publication date: 02/07/2020

Volume: 38

Issue number: 1

Pages range: 58–67

Publisher: American Psychological Association (APA)

Publication country: United States

Publication language: English

DOI: https://doi.org/10.1037/pap0000318

Publication open access:

Publication channel open access:

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/75417

Abstract

Better therapeutic alliances are known to predict better treatment outcomes, but little knowledge still exists on the patient characteristics that lead to better alliances. In a sample of 128 outpatients assigned to long-term psychodynamic psychotherapy and suffering from mood and/or anxiety disorder, this study evaluated how the alliance, measured using the Working Alliance Inventory (WAI), is predicted by three different measures for assessing psychological resources and vulnerabilities: the Wechsler Adult Intelligence Scale—Revised (WAIS–R), the Defense Style Questionnaire (DSQ), and the Rorschach-based Ego Impairment Index (EII-2). All the three measures showed some ability to predict the development of the alliance during long-term therapy. The WAIS–R was found to be the strongest independent predictor, with higher intelligence scores predicting favorable development of both the patient- and therapist-rated alliance. Lower DSQ values, indicating less use of immature defenses, predicted greater improvement in the patient- but not the therapist-rated alliance. Higher EII-2 values, indicating more problematic ego functioning, predicted likewise greater patient-rated alliance improvement over the course of treatment. These findings support the value of pretreatment multimethod psychological assessment when tailoring treatment to the individual needs of patients.

Keywords: psychotherapy; anxiety; anxiety disorders; research methods; measuring instruments (indicators)

Free keywords: Wechsler Adult Intelligence Scale—Revised; Defense Style Questionnaire; Rorschach; Ego; Impairment Index; Working Alliance Inventory

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2021

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