ASSESSING THE THERAPEUTIC RELEVANCE OF INSIGHT.
Item
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Title
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ASSESSING THE THERAPEUTIC RELEVANCE OF INSIGHT.
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Identifier
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AAI8801731
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identifier
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8801731
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Creator
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LINSNER, JEROME PAUL.
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Contributor
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Paul L. Wachtel
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Date
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1987
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical
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Abstract
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The generic concept of "emotional" versus "intellectual" insight has not enabled therapists to reliably evaluate patient progress. This study used a case-specific insight scale to demonstrate a new clinical model for assessing the therapeutic relevance of insight. The crucial distinction was whether patients' insights facilitate or obstruct their efforts to carry out their inferred, unconscious "plan" for therapy.;The research was conducted within the conceptual framework developed by Joseph Weiss (Control Mastery theory). According to this psychoanalytic model, the patient enters treatment motivated to resolve his conflicts, which he does primarily by testing his unconscious pathogenic beliefs in relation to the therapist. Therapeutic progress hinges on whether the therapist passes or fails the patient's "tests".;Shifts in insight associated with a patient's advances and retreats were studied, utilizing transcribed recordings of a short-term dynamic therapy. The Plan Compatibility of Insight Rating Scale (PCIRS) was developed and applied by clinical judges to pre- and post-test segments of patient speech. PCIRS ratings were correlated with ratings of therapist behavior and other indices of patient functioning from previous studies by others in the field (Scale of Therapist Passing Versus Failing Patient Tests; Experiencing Scale; Adaptive Regression Scale; Long-Term Voice Spectrum).;Interjudge reliability on the PCIRS was high. Results supported the hypothesis that "pro-plan" insights would tend to be associated with signs of increased adaptive regression and decreased anxiety, while "anti-plan" insights would tend to manifest the opposite relationships. Predictions that pro-plan insights would be more likely to appear following passed rather than failed tests, whereas anti-plan insights would tend to appear following failed tests, were also supported. In addition, the case-specific PCIRS showed a significant relationship between insight and therapist behavior, whereas the generic constructs used to measure insight with the alternative Experiencing Scale did not.;The concept of plan compatibility was shown to provide a clinically useful model for identifying characteristics of therapeutically relevant insight, for describing the conditions under which it arises, and for assessing the patient's progress. The increased efficacy of utilizing case-specific criteria over generic constructs to evaluate subprocesses related to insight was also demonstrated.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
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Program
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Psychology
