Manual for Transference Work Scale; a micro-analytical tool for therapy process analyses

Randi Ulberg, Svein Amlo, Per Høglend, Randi Ulberg, Svein Amlo, Per Høglend

Abstract

Background: The present paper is a manual for the Transference Work Scale (TWS). The inter-rater agreement on the 26 TWS items was good to excellent and previously published. TWS is a therapy process rating scale focusing on Transference Work (TW) (i.e. analysis of the patient-therapist relationship). TW is considered a core active ingredient in dynamic psychotherapy. Adequate process scales are needed to identify and analyze in-session effects of therapist techniques in psychodynamic psychotherapy and empirically establish their links to outcome. TWS was constructed to identify and categorize relational (transference) interventions, and explore the in-session impact of analysis of the patient-therapist relationship (transference work). TWS has sub scales that rate timing, content, and valence of the transference interventions, as well as response from the patient.

Methods: Descriptions and elaborations of the items in TWS are provided. Clinical examples of transference work from the First Experimental Study of Transference Interpretations (FEST) are included and followed by examples of how to rate transcripts from therapy sessions with TWS.

Results: The present manual describes in detail the rating procedure when using Transference Work Scale. Ratings are illustrated with clinical examples from FEST.

Conclusion: TWS might be a potentially useful tool to explore the interaction of timing, category, and valence of transference work in predicting in-session patient response as well as treatment outcome. TWS might prove especially suitable for intensive case studies combining quantitative and narrative data.

Trial registry name: First Experimental Study of Transference-interpretations (FEST307/95).

Registration number: ClinicalTrials.gov Identifier: NCT00423462. URL: https://ichgcp.net/clinical-trials-registry/NCT00423462?term=FEST&rank=2.

References

    1. Diamond D, Yeomans FE, Clarkin JF, Levy KN. Mentalization and Attachment in Borderline Patients in Transference Focused Psychotherapy. In: Jurist E, Slade A, Bergner S, editors. Mind to Mind: Infant Research, Neuroscience and Psychoanalysis. New York: Other Press; 2008. pp. 167–201.
    1. Ogrodniczuk J, Piper WE. The Evidence: Transference Interpretations and Patient Outcomes-a Comparison of “Types of Patients”. In: Charman DP, editor. Core Process in Brief Psychodynamic Psychotherapy. Advancing Effective Practice. New Jersey/London: Lawrence Erbaum Associates, publishers; 2004. pp. 165–184.
    1. Høglend P, Gabbard GO. When is Transference Work Useful in Dynamic Psychotherapy. In: Levy RA, Ablon JS, Kachele H, editors. Psychodynamic Psychotherapy Research: Evidence Based Practice and Practice Based Evidence. New York, NY: Springer; 2012. pp. 449–467.
    1. Levy KN, Scala JW. Transference, transference interpretations, and transference-focused psychotherapies. Psychother Theory Res Pract. 2012;49:391–403. doi: 10.1037/a0029371.
    1. Ulberg R, Amlo S, Høglend P. Transference interventions and the process between therapist and patient. Psychotherapy. 2014;51:258–269. doi: 10.1037/a0034708.
    1. Town JM, Diener MJ, Abbass A, Leichsenring F, Driessen E, Rabung S. A meta-analysis of psychodynamic psychotherapy outcomes: evaluating the effects of research-specific procedures. Psychotbherapy. 2012;49:276–290. doi: 10.1037/a0029564.
    1. Ogrodniczuk JS, Piper WE. Measuring therapist technique in psychodynamic psychotherapies: development and use of a new scale. J Psychother Pract Res. 1999;8:142–154.
    1. Trijsburg RW, Frederiks GCFJ, Gorlee M, Klouwer E, den Hollander AM, Duivenvoorden HJ. Development of the Comprehensive Psychotherapeutic Interventions Rating Scale (CPIRS) Psychother Res. 2002;12:287–317. doi: 10.1093/ptr/12.3.287.
    1. Waldron S, Scharf RD, Hurst D, Firestein SK, Burton A. What happens in a psychoanalysis? A view through the lens of the analytic process scales (APS) Int J Psychoanal. 2004;85:443–466. doi: 10.1516/5PPV-Q9WL-JKA9-DRCK.
    1. Hilsenrot MJ, Blagys MD, Ackerman SJ, Bonge DR, Blais MA. Measuring psychodynamic-interpersonal and cognitive-behavioral techniques: development of the comparative psychotherapy process scale. Psychother Theory Res Pract Training. 2005;42:340–356. doi: 10.1037/0033-3204.42.3.340.
    1. Jones EE. (1985, Rev 2009). Psychotherapy Process Q-set Coding Manual. Berkeley: University of California; 1985.
    1. Milbrath C, Bond M, Cooper S, Znoj H, Perry JC. Sequential consequences of therapist interventions. J Psychother Prac Res. 1999;8:40–54.
    1. Carter JD, Crowe M, Carlyle D, Frampton CM, Jordan J, McIntosh VV, O’Toole VM, Whitehead L, Joyce PR. Patient change processes in psychotherapy: development of a new scale. Psychother Res. 2012;22:115–126. doi: 10.1080/10503307.2011.631195.
    1. McCullough L, Kuhn N, Andrews S, Valen J, Hatch D, Osimo F. The reliability of the Achievement of Therapeutic Objectives Scale (ATOS): a research and teaching tool for psychotherapy. J Brief Therapy. 2004;2:75–90.
    1. Bøgwald K-P, Høglend P, Sørbye Ø. Measurement of transference interpretations. J Psychother Prac Res. 1999;8:264–273.
    1. Høglend P, Amlo S, Marble A, Bøgwald K-P, Sørbye Ø, Sjaastad MC, Heyerdahl O. Analysis of the patient-therapist relationship in dynamic psychotherapy: an experimental study of transference interpretations. Am J Psychiatry. 2006;163:1739–1746. doi: 10.1176/appi.ajp.163.10.1739.
    1. Høglend P, Bøgwald KP, Amlo S, Marble A, Ulberg R, Sjaastad MC, Sørbye Ø, Heyerdahl O, Johansson P. Transference interpretations in dynamic psychotherapy: do they really yield sustained effects? Am J Psychiatry. 2008;165:763–771. doi: 10.1176/appi.ajp.2008.07061028.
    1. Gabbard GO. Long-Term Psychodynamic Psychotherapy: A Basic Text. 2. Arlington, VA: American psychiatric Publishing; 2010.
    1. Høglend P, Bøgwald K-P, Amlo S, Heyerdahl O, Sørbye Ø, Marble A, Sjaastad MC, Bentsen H. Assessment of change in dynamic psychotherapy. J Psychother Pract Res. 2000;9:190–199.
    1. Alden LE, Wiggins JS, Pincus AL. Construction of circumplex scales for the inventory of interpersonal problems. J Pers Assess. 1990;55:521–536. doi: 10.1207/s15327752jpa5503&4_10.
    1. Derogatis LR. SCL-90-R: Administration, Scoring and Procedures Manual II. Towson, Md: Clinical Psychometric Research; 1983.
    1. Høglend P. Manual for Process Ratings of General Skill, Supportive Interventions, and Specific Techniques. Oslo: Norway, University of Oslo, Department of Psychiatry; 1994.
    1. Høglend P, Dahl HS, Hersoug AG, Lorentzen S, Perry JC. Long-term effects of transference interpretation in dynamic psychotherapy of personality disorders. Eur Psychiatry. 2011;26:419–424. doi: 10.1016/j.eurpsy.2010.05.006.
    1. Johansson P, Høglend P, Ulberg R, Amlo S, Marble A, Bøgwald KP, Sørbye Ø, Sjaastad MC, Heyerdahl O. The mediating role of insight for long-term improvements in psychodynamic therapy. J Consult Clin Psychol. 2010;78:438–448. doi: 10.1037/a0019245.
    1. Ulberg R, Høglend P, Marble A, Johansson P. Women respond more favorably to transference intervention than men: a randomized study of long-term effects. J Nerv Ment. 2012;200:223–229. doi: 10.1097/NMD.0b013e318247cb6d.
    1. Ulberg R, Marble A, Høglend P. Do gender and level of relational functioning influence the long-term treatment response in dynamic psychotherapy? Nord J Psychiatry. 2009;63:412–419. doi: 10.1080/08039480903009126.
    1. Høglend P, Hersoug AG, Bøgwald KP, Amlo S, Marble A, Sørbye Ø, Røssberg JI, Ulberg R, Gabbard GO, Crits-Christoph P. Effects of transference work in the context of therapeutic alliance and quality of object relations. J Consult Clin Psychol. 2011;79:697–706. doi: 10.1037/a0024863.
    1. Strachey J. The nature of the therapeutic action of psycho-analysis. J Psychother Pract Res 1934. 1999;8:66–82.
    1. Greenson RR. The Thechnique and Practice of Psychoanalysis. New York: International Universities Press Inc; 1975. pp. 372–373.
    1. Samberg E, Marcus ER. Process, Resistance, and Interpretation. In: Person ES, Cooper AM, Gabbard GO, editors. Textbook of Psychoanalysis. Washington DC, London: American Psychiatric Publishing Inc; 2005. pp. 229–237.
    1. Malan D. The Frontier of Brief Psychotherapy. New York: Plenum; 1976.
    1. Gabbard GO, Westen D. Rethinking therapeutic action. Int J Psychoanal. 2003;84:823–841. doi: 10.1516/N4T0-4D5G-NNPL-H7NL.
    1. Ulberg R, Amlo S, Hersoug AG, Dahl HS, Høglend P. The effects of the therapist’s disengaged feelings on the in-session process in psychodynamic psychotherapy. J Clin Psychol. 2014;70:440–451. doi: 10.1002/jclp.22088.
    1. Benjamin LS, Cushing G. Reference Manual for Coding Social Interactions in Terms of Structural Analysis of Social Behavior. Salt Lake City: University of Utah; 2000.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe