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An interpersonal model of psychotherapy: linking patient and therapist developmental history, therapeutic process, and types of outcome.

This study empirically evaluated a 3-stage causal model based on interpersonal theory that relates patient and therapist early parental relations, the therapeutic alliance, and outcome. Data were from the Vanderbilt II database and encompassed 64 psychodynamic psychotherapies. Interpersonal variables were assessed using the Structural Analysis of Social Behavior. Initial support for the model was found, suggesting a direct effect of patient early parental relations on process and outcome, a direct effect of therapist early parental relations on process, and a direct effect of process on outcome--and thus indirect effects of both patient and therapist early parental relations on outcome mediated by the process. The psychotherapy process was assessed from 3 perspectives: patient and therapist self-report and reports by independent observers. Little convergence was found between the 3 perspectives.