Changes in relationship patterns of inpatients following brief psychodynamic psychotherapy

Abstract

Aim: to find possible changes in relationship patterns of non-psychotic psychiatric inpatients occurring after brief psychodynamic therapy, and their correlations with clinical and subjective improvement in the patients' condition; to test the validity and applicability of the Core Conflictual Relationship Theme (CCRT) method in Ukrainian culture and language. Material and Methods. Participants of the study were comprised of inpatients of the psychotherapy clinic of the Department of Psychiatry and Psychotherapy of the Danylo Halytsky National Medical University in Lviv, Ukraine. All patients were diagnosed with non-psychotic psychiatric disorders based on ICD-10, and assigned 10 sessions of individual brief psychodynamic psychotherapy. The study followed a naturalistic design. The main method used in the study was the Core Conflictual Relationship Theme (CCRT) method. Before therapy, all patients participated in a recorded semi-structured interview narrating ten specific interactions (relationship episodes) with one significant person of their choice. Each episode was to include three components: wishes of patients in relation to another person; responses of the other person to their wishes; responses of the self to the responses of the other. The most important combinations of these components constituted the core conflictual relationship themes of patients. The components were extracted from narratives and translated into standard CCRT categories of the CCRT-LU (Leipzig-Ulm) category system. Before treatment, patients also filled in the Symptom Checklist Scale-90 (SCL-90) questionnaire to assess their psychopathological symptoms. Patients who completed the course of psychotherapy underwent another interview containing relationship episodes, and filled in two questionnaires - the SCL-90 (for the second time) and the Questionnaire of Changes in Experiencing and Behavior - VEV-test. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS), version 23.0, and Microsoft Excel software. Results and Discussion. Out of 51 patients examined, 30 completed the ten-session course of treatment, while 21 dropped out for various reasons. Before treatment, the rate of harmonious responses of others in relationship episodes of patients equaled 27.52% versus 72.48% of the disharmonious; the rate of harmonious responses of self was 23.49% versus 76.51% of the disharmonious. After treatment, the rate of harmonious responses of others increased to 40.26%, while the rate of the disharmonious decreased to 59.74% (pЈ0.001); the rate of harmonious responses of self increased to 43.38%, while the rate of the disharmonious dropped to 56.62% (pЈ0.001). The improvement of relationship patterns in patients after psychotherapy correlated significantly with alleviation of the psychopathological symptoms (according to SCL-90 scores) and the patients' subjective evaluation of psychotherapy effectiveness according to VEV-test results (pЈ0.05, pЈ0.01, pЈ0.001). Conclusions: the Ukrainian version of the CCRT method can be validly applied in psychotherapy research in Ukraine. Patients who received brief inpatient psychodynamic psychotherapy perceive their interpersonal relationships as more positive and harmonious; these changes correlate with improvement of the patients' psychopathology according to the SCL-90 and with the patients' positive evaluation of psychotherapy effectiveness according to the VEV-test results.

Keywords

• psychotherapy effectiveness, inpatient psychotherapy, core conflictual relationship theme