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FOREWORD
FOREWORD
PREFACE
ACKNOWLEDGMENTS
PROJECT PARTICIPANTS
I THE BASICS OF THE CCRT METHOD AND ITS SCORING
THE EARLY LIFE OF THE IDEA FOR THE CORE CONFLICTUAL RELATIONSHIP THEME METHOD
THE LINEAGE OF THE CENTRAL RELATIONSHIP PATTERN CONCEPT
From the Psychoanalysts
From the Personality Researchers
From the Developmental and the Object Relations Researchers
From the Early Attempts to Develop a Transference Measure
Systematic Clinical Formulation of the Transference Paradigms
Agreement on the Conventional Unguided Transference Formulations
Rating the Amount of Transference
Formulation of the Patient’s Main Communication in a Session as a Focus for Interpretations
Formulation and Rating of the Symptom-Context Theme
CONCLUSION
A GUIDE TO THE CCRT METHOD
PHASE A: LOCATION RELATIONSHIOP EPISODES
Definition of a Relationship Episode
Types of Other Persons in Relationship Episodes
RE: Specific Other People
RE: Therapist
RE: Self
Current Versus Past Relationship Episodes
Completeness of Relationship Episodes
Assignment of Scoring Judges
PHASE B: SCORING THE CCRT
Step 1: Identifying the Types of CCRT Components
Locating and Underlining Parts of the Relationship Episode to Be Scored
Identifying Types of Components
Preparing the Transcript for Scoring
Keeping Within the Range of Levels of Inference From Literal to Moderately Abstract
Step 2: Counting the Types of Components and Formulating the CCRT
Step 1': Re-Identifying the Types of CCRT Components to Make a Final Formulation
Step 2': Recounting and Reformulating the CCRT on the Basis of Step 1'
Step 3: Choosing and Rating the Standard Categories for the CCRT
Options Among Standard Category Lists
Related Lists of Standard Categories
Applications of Standard Categories
System 1
System 2
Detailed Guides for Scoring the Components: Wishes, Responses From Other, and Responses of Self
Wishes
Responses From Other
Responses of Self
Positive and Negative Responses
RO and RO-Expected
OPTIONAL STEPS
Step 4: Distinguishing Between Expressed and Not Expressed Responses of Self
Step 5: Judging the Intensity of Theme Components
Step 6: Recording the Sequence of the Appearance of Each Component
Step 7: Estimating the Patient’s Moment-to-Moment Experience of the Components of the CCRT in the Relationship With the Therapist
Step 8: Randomizing Relationship Episodes Before Scoring
Step 9: Additional Quantitative Specification of the CCRT
SUPPLEMENTARY ISSUES
Estimating Reliability of Tailor-Made Categories
Agreement Judges
Paired Comparisons
The Need of the CCRT Judge for Uniform Background Information About the Patient
The Best Sample Size of Relationship Episodes for Deriving the CCRT
The Use of Dreams and Fantasies
Training Procedures for Learning to Score the CCRT
CONCLUSION
Note
TABLE 1 Completeness Ratings of Hypothetical Relationship Episodes
Figure 1.
Figure 2.
Figure 3.
TABLE 2 Level of Inference in Scoring Wishes
TABLE 3 Intensity Ratings
Appendix A: Summary of Basic Steps for Scoring the CCRT
PHASE A: LOCATING RELATIONSHIP EPISODES
Notations for the Relationship Episodes
PHASE B: EXTRACTING THE CCRT
Step 1
Step 2
Step 1'
Step 2’
Step 3
Step 4
Step 5 (optional)
Step 6 (optional)
Step 7 (optional)
Step 8 (optional)
Step 9 (optional)
NOTATIONS FOR THE CCRT COMPONENTS
Steps 1—2 and 1'—2'
Wishes
Responses From Other
Responses of the Self
APPENDIX B
WISHES
RESPONSES FROM OTHER
RESPONSES OF SELF
A GUIDE TO THE CCRT STANDARD CATEGORIES AND THEIR CLASSIFICATION
DEVELOPMENT OF THE STANDARD CATEGORIES
PROCEDURE FOR A CLUSTER-BASED CLASSIFICATION
RESULTS
DISCUSSION
Wishes
Responses From Others
Responses of Self
CONCLUSIONS
EXHIBIT 1 A Standard List of Scoring Categories: Edition 1 Based on the CCRT in a Normative Group (n = 16)
TABLE 1 Standard CCRT Categories: Edition 2
Table 1 cont.
Table 1 cont.
TABLE 2 CCRT Clustered Standard Categories; Edition 3
POSITIVE VERSUS NEGATIVE CCRT PATTERNS
RELIABILITY OF SCORING THE POSITIVE AND NEGATIVE DIMENSIONS OF THE CCRT
The Two-Category System
A New Four-Category Positive and Negative Scale
PROPORTION OF POSITIVE AND NEGATIVE NARRATIVES IN CHILDREN, ADULT PATIENTS, AND NORMAL CONTROLS
CHANGES IN POSITIVE AND NEGATIVE DIMENSIONS OVER THE COURSE OF PSYCHOTHERAPY
RELATIONSHIP TO PSYCHOTHERAPY OUTCOMES
CONCLUSION
Note
Figure 1.
Figure 2.
TABLE 1 Pearson Correlations Between Positive and Negative CCRT Response of Other (RO) and Response of Self (RS) Scores with the Health-Sickness Rating Scale (HSRS) and Mastery Scale
ILLUSTRATIONS OF THE CCRT SCORING GUIDE
MS. SMYTH: SHORT-TERM PSYCHODYNAMIC PSYCHOTHERAPY
Clinical Evaluation
Initial
Termination
Six-Month Follow-up
CCRT Data and Results
Ms. Smyth: CCRT Scoring of Relationship Episodes Session 3
RE 2: Ex-employers, Completeness Rating 4.0
RE 3: Brother and His Wife, Completeness Rating 4.5
RE 4: Boyfriend, Completeness Rating 5.0
Session 5
RE 5: Father, Completeness Rating 3.0
RE 6: Boss, Completeness Rating 2.5
MR. EDWARD HOWARD: PSYCHOANALYTIC PSYCHOTHERAPY
Clinical Evaluation
Initial
Termination (After About 90 Sessions)
CCRT Data and Results
Mr. Howard: CCRT Scoring of Relationship Episodes (Condensed) Session 3
RE 1: Mother
RE 2: Mother
RE 3: Therapist
RE 4: Mother
RE 5: Girlfriend
RE 6: Mother
Mr. Howard: CCRT Scoring of Relationship Episodes (Condensed) Sessions 82 and 83
RE 1: Therapist (Session 82)
Dream A: Trainers3
RE 2: Boyfriend
Dream B: Store (Session 83)
Dream C: Store Owner
RE 3: Therapist
RE 4: Father
MS. CATHY CUNNINGHAM: PSYCHOANALYSIS
Clinical Evaluation
Initial
Termination (After About 1,300 Sessions)
CCRT Data and Results
Ms. Cunningham: CCRT Scoring of Relationship Episodes (Condensed) Session 5
RE 1: Assistant
RE 3: Husband
RE 4: Boys and parents
RE 5: Therapist
RE 7: Professor
Ms. Cunningham: CCRT Scoring of Relationship Episodes (Condensed) Session 1,208
RE 1: Therapist
RE 2: Self
RE 3: Assistant
RE 4: Husband
RE 5: Self
RE 6: Therapist
CONCLUSIONS
Note
EXHIBIT 1 SYMBOLS FOR CCRT SCORING TO BE APPLIED TO THE RELATIONSHIP EPISODES
TABLE 1 CCRT Score Sheet for Each Relationship Episode, Tailor-Made System
TABLE 2 CCRT Score Sheet, Tailor-Made System: Summary Across All Relationship Episodes
TABLE 3 CCRT Summary: Standard Categories
TABLE 4 CCRT Score Sheet for Each Relationship Episode, Tailor-Made System
TABLE 5 CCRT Score Sheet, Tailor-Made System: Summary Across All Relationship Episodes
TABLE 6 CCRT Summary: Standard Categories
TABLE 7 CCRT Score Sheet for Each Relationship Episode, Tailor-Made System
TABLE 8 CCRT Score Sheet for Each Relationship Episode, Tailor-Made System: Summary Across All Relationship Episodes
TABLE 9 CCRT Summary: Standard Categories
TABLE 10 CCRT Score Sheet for Each Relationship Episode, Tailor-Made System
TABLE 11 CCRT Score Sheet, Tailor-Made System: Summary Across All Relationship Episodes
TABLE 12 CCRT Summary: Standard Categories
TABLE 13 CCRT Score Sheet for Each Relationship Episode, Tailor-Made System
TABLE 14 CCRT Score Sheet, Tailor-Made System: Summary Across All Relationship Episodes
TABLE 15 CCRT Summary: Standard Categories
THE RELIABILITY OF THE CCRT MEASURE: RESULTS FROM EIGHT SAMPLES
AGREEMENT ON THE SELECTION OF RELATIONSHIP EPISODES FROM SESSIONS
Completeness of Each Relationship Episode
Selection of the Main Other Person in Each RE
Location of the Relationship Episode
AGREEMENT ON THE CCRT
The Earliest Study of CCRT Reliability
Agreement on the CCRT for Matched Versus Mismatched Cases
Agreement on the CCRT for One Patient
Sample A: Agreement on the CCRT by Three Independent Judges for 8 Patients
Sample B: The First Large-Scale Study of Interjudge Agreement on the CCRT
Samples C and D: A Comparison of the CCRT in Dreams Versus Narratives
Samples E and F: A Comparison of the CCRT for Session Narratives Versus Relationship Anecdote Paradigm Narratives
Reliability of the CCRT From Psychotherapy Sessions (Sample E)
Reliability of the CCRT from RAP Narratives (Sample F)
Sample G: A Comparison of the CCRTs of Children From Age 3 to Age 5
Percentage of Agreement Between Two Judges
Weighted Kappa Agreement
Sample H: A Comparison of Adolescents at Age 14 and at Age 18 on the Basis of RAP Narratives
Sample I: The Core Conflictual Relationship Themes of Borderline Personality Disorder
CONCLUSIONS
Note
TABLE 1 Summary of Eight Samples for Reliabilities of CCRT Components
THE RELATIONSHIP ANECDOTES PARADIGM (RAP) INTERVIEW AS A VERSATILE SOURCE OF NARRATIVES
ADMINISTRATION OF THE RAP INTERVIEW
Instructions
Improving Rapport and Dealing With Special Contingencies
CHARACTERISTICS OF RAP NARRATIVES
USES OF RAP NARRATIVES
RAP Narratives as Data for the CCRT Measure
Other Uses of the RAP Interview Procedure
As a Database for Studies of Explanatory Style
As a Source of Data for Developmental Studies of Central Relationship Patterns
As a Basis for Studies of Self-Understanding
As a Basis for the Comparison Among Diagnostic Groups
As a Basis for Intergenerational Comparisons
CONCLUSIONS
TABLE 1 Descriptive Characteristics of RAP Narratives in an Outpatient Psychiatric Clinic Sample (N = 24)
TABLE 2 CCRT Score Sheet Summary (Number of Relationship Episodes Containing Each Component)
APPENDIX
The RAP Interview for Mr. Edward Howard: An 8-Year-Follow-up
RE 1: Therapist
RE 2: Work Supervisor
RE 3: Sister
WHY EACH CCRT PROCEDURE WAS CHOSEN
DATABASE DECISIONS
To Rely on Psychotherapy Sessions
To Restrict the Database to Narratives About Relationship Episodes
To Include Behavioral Enactments of the Relationship With the Therapist
SCORING SYSTEM DECISIONS
To Use Guided Judgments
To Identify the Main Other Person Within Each Relationship Episode With Whom the Speaker Is Interacting
To Rely on Three Components of Narratives: Wishes, Responses From Others, and Responses of Self
To Use a Theme Format That Highlights Conflicts
To Judge All Responses as Either Positive or Negative
To Use Both Tailor-Made and Standard Categories
To Rely on Redundancy Across the Narratives (Pervasiveness) as the Indicator of the CCRT
To Allow Only One Score per Relationship Episode for Each Different Category
To Use Our Usual System for Counting All Scorable Components Regardless of Sequence
INFERENCE LEVEL AND FOCUS DECISIONS
To Stay Within the Range of Moderate Inference
To Add a Re-Review of the Relationship Episodes by Steps 1' and 2'
To Focus on the Patient’s Perspective
CONCLUSIONS
II DISCOVERIES FROM THE CCRT METHOD
THE NARRATIVES TOLD DURING PSYCHOTHERAPY AND THE TYPES OF CCRTs WITHIN THEM
NUMBER AND COMPLETENESS OF NARRATIVES
LENGTH OF NARRATIVES TOLD DURING THERAPY SESSIONS
MAIN OTHER PEOPLE IN NARRATIVES
CCRTs OF PATIENTS
TYPES OF TAILOR-MADE CCRTs WITHIN NARRATIVES
TYPES OF STANDARD CATEGORY CCRTs WITHIN NARRATIVES
CCRT SEQUENCES OF COMPONENTS FOR THE WISH TO BE CLOSE VERSUS THE WISH TO BE INDEPENDENT
The Wish to Be Close or Be Loved
The Wish to Be Independent
COMPARISON OF THE SEQUENTIAL CCRT AND THE REGULAR CCRT
POSITIVE VERSUS NEGATIVE RESPONSES WITHIN CCRTs
DIFFERENCES IN CCRTs BY DIAGNOSIS (DYSTHYMIA AND NONDYSTHYMIA)
RESULTS, DISCUSSION, AND CONCLUSIONS
TABLE 1 Frequency of Different Other Persons in Narratives (N = 33)
TABLE 2 Tailor-Made CCRT Categories for the Penn Psychotherapy Project Sample (N = 33) With Subsamples of Dysthymic (n = 12) and Nondysthymic (n = 21) Groups
TABLE 3 Clustered Standard Categories Within Narratives for Penn Psychotherapy Project Sample (N = 33) With Subsamples of Dysthymic (n = 12) and Nondysthymic (n = 21) Groups
TABLE 4 Most Frequent Tailor-Made and Standard Clustered Categories for the Penn Psychotherapy Project Sample (N = 33)
TABLE 5 Positive Versus Negative CCRT Components Related to the Therapist or Others
CHANGES IN CCRT PERVASIVENESS DURING PSYCHOTHERAPY
PROCEDURE
Combination of Judges’ CCRT Formulations
Patients and Therapists
Treatment, Sessions, and Judges
RESULTS
CCRT Pervasiveness Scores Were Highly Reliable
Measures of CCRT Change Were Low to Moderately Intercorrelated
CCRT Pervasiveness Was Greatest for the Wishes
CCRT Pervasiveness Decreased From Early to Late in Therapy
Some Early-in-Therapy Pervasiveness Scores Were Related to Initial Symptoms and to Initial Health–Sickness
Change in CCRT Pervasiveness Was Moderately Correlated With Change in Symptoms and Change in Health-Sickness
DISCUSSION
Reliability of Pervasiveness Score
CCRT Pervasiveness Across the Narratives
CCRT Pervasiveness Changes in Therapy
CCRT Change Tends to Correlate With Symptom Reduction
Limitations of the Measure of CCRT Pervasiveness
CONCLUSIONS
Note
TABLE 1 Intercorrelations of CCRT Pervasiveness Change Measures (Residual Gain Scores)
TABLE 2 Mean Percentages Early and Late in Treatment for CCRT Pervasiveness Scores (N = 33)
TABLE 3 Partial Correlations of Change in CCRT Pervasiveness Measures With Change in Symptoms and Change in Health-Sickness
THE PARALLEL OF THE CCRT FOR THE THERAPIST WITH THE CCRT FOR OTHER PEOPLE
AIMS AND PROCEDURES
Phase 1: Formulating Other Person-CCRTs
Phase 2: Comparing Other Person-CCRTs With Therapist-REs
RESULTS
Interjudge Reliability of the CCRT Was Adequate
Therapist-REs and Other Person-CCRTs Showed Similarity
Similarity Was Greater for Cases With Three or More Therapist-REs
THE DIRECTIONS THAT LEAD FROM HERE
Increasing the Number of Relationship Episodes
Examining Concomitants of Different Other Persons
Improving the Level of Similarity of Therapist-REs and Other Person-REs
CONCLUSIONS
Figure 1.
Figure 2.
Figure 3.
Figure 4.
Figure 5.
THE PARALLEL OF THE CCRT FROM WAKING NARRATIVES WITH THE CCRT FROM DREAMS
STUDY 1: THE PARALLEL OF THE CCRT FROM WAKING NARRATIVES WITH THE CCRT FROM DREAMS[7]
Selection of Dreams, Narratives, and Judges
CCRT Tailor-Made and Standard Categories
Results
Ms. Apfel (Case 1)
Wishes Derived From Dreams Plus Associations and From Dreams Plus Whole Sessions
Ms. Bauman (Case 2)
Mr. Crane (Case 3)
Summary and Discussion
STUDY 2: THE PARALLEL OF THE CCRT FROM WAKING NARRATIVES WITH THE CCRT FROM DREAMS: A FURTHER VALIDATION
Method
Results
Reliability
Common Types of CCRT Components in Dreams and Narratives
Similarity Between Dream and Narrative CCRT Components
Negativity of Responses
SUMMARY AND CONCLUSIONS
Note
TABLE 1 Tailor-Made Wishes Scored From Dreams Alone for Ms. Apfel
TABLE 2 Standard Category Wishes for Ms. Apfel
TABLE 3 Standard Category Responses From Other or of Self for Ms. Apfel
TABLE 4 Standard Category Wishes and Responses From Other or of Self for Ms. Bauman
TABLE 5 Standard Category Wishes and Responses From Other or of Self for Mr. Crane
TABLE 6 Agreement by Weighted Kappa of Two Judges in Scoring the CCRT
TABLE 7 Percentage of Cases in Which a Standard Category CCRT Cluster Appeared as the First Rank, Most Frequent CCRT Cluster
TABLE 8 Number of Participants With the Same Highest Frequency Clusters in Dreams and Narratives
TABLE 9 Negativity of CCRT Components
THE MEASUREMENT OF ACCURACY OF INTERPRETATIONS
PROCEDURES
Patients
Therapist and Treatment Characteristics
Measures
Identifying Interpretations
Combining Judges’ CCRT Formulations
Accuracy of Interpretations
Errors in Technique Scale
Helping Alliance Counting Signs Scale
Treatment Outcome
RESULTS
The Average Level of Accuracy of Interpretations Was Low
The Predictors of Accuracy Were Unrelated to Each Other
Accuracy of the Wish Plus Response From Other Was the Best Predictor of Outcome
The Impact of Accurate Interpretations Was Not Limited to When the Alliance Was Positive
DISCUSSION
Congruence of Interpretations With the CCRT
Noninteraction With the Helping Alliance
Nonsignificant Relationship With the Errors in Technique Scale
Limits of Correlational Findings
CONCLUSIONS
Note
TABLE 1 Characteristics of Patients (N = 43)
TABLE 2 Patient Diagnosis (N = 43)
Figure 1.
Figure 2.
TABLE 3 Means and Standard Deviations for Accuracy Dimensions (N = 43)
TABLE 4 Intercorrelations of Predictors
TABLE 5 Prediction of Outcome by Accuracy, Helping Alliance, and Errors in Technique Measures (N = 43)
SELF-UNDERSTANDING OF THE CCRT
PROCEDURE
Patients and Sessions
Measures
The CCRT Measure
Self-Understanding of the CCRT
Health-Sickness Rating Scale
Outcome Measures
RESULTS
Reliability of Judging Self-Understanding Was Good
Level of Self-Understanding Was Low
Level of Self-Understanding Predicted Outcome; Change in Self-Understanding Did Not
SUMMARY, DISCUSSION, AND CONCLUSIONS
The Findings and Their Meaning
The Search for Better Operational Measures
Note
TABLE 1 Interjudge Reliability of the Self-Understanding Scale
TABLE 2 Mean Self-Understanding for Session 3 and Session 5 (N = 43)
TABLE 3 Prediction of Outcome From Level of and Change in Self-Understanding (N = 43)
THE PERSPECTIVE OF PATIENTS VERSUS THAT OF CLINICIANS IN THE ASSESSMENT OF CENTRAL RELATIONSHIP THEMES
AIM
PROCEDURE
RESULTS
Self-Report CCRT Questionnaire (SR-CCRT)
Retest Reliability Was Moderate; Internal Consistency Was Marginal
Three Factors Were Found
Self-Interpretation of the RAP Interview
Consistency Over Narratives Was High
Correlation With the Self-Report CCRT Was Poor
Clinical Judge’s Scoring: Comparisons With Self-Report and Self-Interpretation
Patients Tended to Give High Ratings to Wishes Identified by the Clinicians
SUMMARY AND DISCUSSION
CONCLUSION
EXHIBIT 1 Wishes Rated in the CCRT Self-Report Questionnaire
TABLE 1 Reliability of Self-Report CCRT Questionnaire on Wishes
TABLE 2 Factor Analysis of Wishes
TABLE 3 Self-Interpretation of RAP: Consistency of Wishes Across 10 Relationship Episodes
TABLE 4 Correlations Between Self-Report and Self-Interpretation
TABLE 5 Comparison of Patient’s Report With Clinician-Identified Wishes
STABILITY OF THE CCRT FROM AGE 3 TO 5
BACKGROUND OF RELATED RESEARCH
Clinical Retrospection
Infancy Research
Narratives Told by Young Children
PROCEDURE
Subjects
A Doll Family Story Method For Collecting Narratives
Data Analyses
An Example of a Scored Narrative
Compliance of 3- and 5-Year-Olds With the Narrative-Telling Task
RESULTS
Do the Judges Agree in Scoring the CCRT?
How Pervasive Are the Clusters of CCRT Standard Categories Within Narratives at Age 3 and Age 5?
Is There a Core Relationship Theme for Each Child?
How Constant Does Each Child’s Profile of Clusters Remain From Age 3 to Age 5?
How Constant From Age 3 to Age 5 Were the Highest Clusters of the CCRT Patterns?
How Positive and How Negative Were the Relationship Patterns at Ages 3 and 5?
Are There Gender Differences in Central Relationship Patterns at Ages 3 and 5?
SUMMARY, DISCUSSION, AND CONCLUSIONS
WHAT IS NEXT IN THIS LINE OF RESEARCH?
Notes
Figure 1. "Lost Car Keys" Story
Figure 2.
TABLE 1 Comparison of Children at Ages 3 and 5 for the Number of Times Highest or Next Highest for Each Wish Cluster (N = 19)
TABLE 2 Comparison of Children at Ages 3 and 5 for the Number of Times Highest or Next Highest for Each Response From Other Cluster (N = 18)
Table 3 Comparison of Children at Ages 3 and 5 for the Number of Times Highest or Next Highest for Each Response of Self Cluster (N = 18)
TABLE 4 Positive and Negative CCRT Responses (Percentages)
STABILITY OF THE CCRT FROM BEFORE PSYCHOTHERAPY STARTS TO THE EARLY SESSIONS
METHOD
The Core Conflictual Relationship Theme Method
The RAP Interview Method
Procedure
RESULTS
Reliability of the CCRTs Derived From the RAP Interviews
Reliability of the CCRTs Derived From Therapy Sessions
Correspondence Between CCRTs From RAPs (Before Therapy) and CCRTs From Sessions
CONCLUSIONS
Note
TABLE 1 Interjudge Agreement and Reliability for the CCRT From the RAP Interview and Therapy Sessions, and Comparisons of CCRTs From RAP Interview Versus Therapy Sessions
THE MEASUREMENT OF MASTERY OF RELATIONSHIP CONFLICTS
MEASUREMENT OF MASTERY
METHOD
RESULTS
SUMMARY, DISCUSSION, AND CONCLUSIONS
Note
TABLE 1 Mastery Scale, Version I
TABLE 2 Pearson Correlations Between Mastery Scale Residual Change Scores and Clinical Outcome Scores
Figure 1.
Figure 2.
III CLINICAL USES OF THE CCRT
THE EVERYDAY CLINICAL USES OF THE CCRT
THE USES OF THE CCRT IN DYNAMIC PSYCHOTHERAPY
As a Guide to Formulations and Interpretations
As an Aid to Maintaining a Treatment Focus
As a Help in Choosing a Part of the CCRT for Each Interpretation
As a Help in Timing Interpretations
As a Clue to the Conflicts Sparking the Formation of Symptoms
As a Supplement to DSM Diagnoses
As a Special Aid in the Functioning of Inpatient Units
THE DIFFERENT CONSEQUENCES OF DIFFERENT PSYCHOTHERAPEUTIC SYSTEMS ON THE INTERPRETATIVE FOCUS
Dynamic Therapy
CCRT-Guided Dynamic Therapy
Davanloo’s Therapy
Sifneos’s Therapy
Mann’s Therapy
Cognitive Therapy
PROCEDURES FOR THERAPISTS TO LEARN TO RELY ON THE CCRT IN PSYCHOTHERAPY
Instruction in the CCRT During Supervision
Scoring Practice Sets of Relationship Episodes
Practice With CCRT-Based Interpretations During Tape Playbacks
Training Through a Self-Reported and Self-Analyzed CCRT
Training in the CCRT During Psychiatric Residency: A Survey of Therapists’ Benefits
CONCLUSIONS
Figure 1.
ALTERNATIVE MEASURES OF THE CENTRAL RELATIONSHIP PATTERN
SKETCHES OF THE ALTERNATIVE METHODS
Plan Diagnosis
Structural Analysis of Social Behavior (SASB)
Configurational Analysis
Frame
Script Theory
Patient’s Experience of the Relationship with the Therapist (PERT)
Cyclical Maladaptive Pattern (CMP)
Plan Analysis (PA)
Impact Message Inventory, Form IIA (IMI)
Clinical Evaluation Team
The Seattle Psychotherapy Language Analysis Schema
The Check List of Psychotherapy Transactions-Revised (CLOPT-R) and the Check List of Interpersonal Transactions-Revised (CLOIT-R)
Idiographic Conflict Formulation (ICF)
Consensual Response Formulation
Quantitative Analysis of Interpersonal Themes (QUAINT)
Personal Scripts
COMPARISONS AMONG METHODS OF MEASURING CENTRAL RELATIONSHIP PATTERNS
QUESTIONNAIRE MEASURES OF TRANSFERENCE PATTERNS
SUMMARY, DISCUSSION, AND CONCLUSIONS
Note
TABLE 1 Central Relationship Pattern Measures Based on Sessions
IV WHAT’S NOW AND WHAT’S NEXT
THE CONVERGENCE OF FREUD’S OBSERVATIONS ABOUT TRANSFERENCE WITH THE CCRT EVIDENCE
FREUD’S OBSERVATIONS COMPARED WITH CCRT EVIDENCE
DISCUSSION
The Nature of Freud’s Observations
The Correspondence of Freud’s Observations With CCRT Evidence
CONCLUSIONS
TABLE 1 Freud’s “Transference Template” Observations and the CCRT Evidence
Figure 1
WHERE WE ARE IN UNDERSTANDING THE CCRT
HOW MUCH MORE RELIABLE IS THE CCRT METHOD THAN THE USUAL CLINICAL METHOD?
DO TAILOR-MADE OR STANDARD CATEGORIES WORK BETTER?
MIGHT THE TRANSFERENCE BE A MERE PRODUCT OF SUGGESTION BY THE THERAPIST?
IS THE CCRT FROM THERAPY NARRATIVES SIMILAR TO THE CCRT FROM RAP NARRATIVES?
ARE RAP NARRATIVES ABOUT “REAL” EVENTS SIMILAR TO “STORIES” FROM THE TAT?
WOULD BEHAVIORAL ENACTMENTS OF RELATIONSHIPS REVEAL MORE THAN THE USUAL NARRATIVES ABOUT RELATIONSHIPS?
WHAT WOULD BE LEARNED FROM SCORING SEQUENCES OF CCRT COMPONENTS?
ARE DEFENSES CLASSIFIABLE WITHIN THE RESPONSES OF SELF?
HOW CAN THE OBSERVATION BE TESTED THAT THE TRANSFERENCE IS “PARTLY OUT OF AWARENESS”
WHY RELY ON NARRATIVES ABOUT RELATIONSHIPS AS THE BASIS FOR THE CCRT?
Characteristics of Narratives
The Truth Value of Narratives
The Revelations of Narratives About Modes of Thought
The Interpretability of Narratives
HOW DID EACH PERSON’S CCRT ORIGINATE AND WHY IS IT SO PERSISTENT?
Source Factor 1: Learning the Pattern From Parental Figures
Source Factor 2: Needing to Gratify Certain Pressing Wishes
Source Factor 3: Repeating of Traumatic Ideas and Scenes
Source Factor 4: Repeating in the Service of Mastery
HOW MUCH DOES THE CCRT CORRESPOND WITH THE TRANSFERENCE?
CONCLUSIONS
REFERENCES
ABOUT THE AUTHORS