Patients' testing activity in psychotherapy, therapeutic alliance and treatment outcome

According to Control-Mastery Theory (Gazzillo, 2021; Silberschatz, 2005; Weiss, 1993), people come to therapy with an unconscious plan to overcome their pathogenic beliefs. The primary way patients work in therapy to disconfirm their pathogenic beliefs is by testing them in the therapeutic relationship. Previous studies suggest that therapist’s pro-plan responses to patient tests are predictive of patient’s within-session progress (e.g., Silberschatz & Curtis, 1993). The aim of this study is partly to replicate the results of previous research, but also to investigate whether these interventions are predictive of treatment outcome and strong therapeutic alliance. The transcripts of five brief psychodynamic psychotherapies were studied. For each case, the patients’ plan was formulated, patients’ tests were identified, the case-specific accuracy of the therapists responses to these incidents was rated, and the impact of these interventions on subsequent patient’s affect and behavior, on therapeutic alliance and on treatment outcome was measured. If our predictions are confirmed, the results of this study may increase our understanding of the link between psychotherapy processes and treatment outcome.