Research in psychotherapy: proceedings of a conference, Washington, D.C., April 9-12, 1958

302 Pages·1959·20.404 MB·English

by  Eli A. Rubinstein, Morris B. Parloff (editors)

RESEARCH PSYCHOTHERAPY
IN
RESEARCH
IN
PSYCHOTHERAPY
Proceedings of a Conference,
Washington, D. C., April 9-12, 1958
Eli A. Rubinstein
Morris B. Parloff, Editors
This conference, financed by a grant (M-2031)
from the National Institute of Mental Health,
U. S. Public Health Service, was held under the
auspices of the Division of Clinical Psychology,
American Psychological Association, with plan-
ning and programming by Ad Hoc Committee
an
of the Division of Clinical Psychology; Frank
Auld, Jr., Moms B. Parloff, Benjamin Pasa-
manick, George Saslow, Julius Seeman, and Eli A.
Rubinstein, Chairman.
Copyright 1959 by the
AMERICAPNS YCHOLOGICAASSLO CIATIOINN,C .
1333 Sixteenth St., N.W.
Washington, D. C.
All rights reserved
No part of this book may be reproduced
in any form without permission
in writing from the publisher
Library of Congress Catalog Card Number 59-9192
Table of Contents
Page
Contents ......................................................... iii
Preface ........................................................ V
Members of the Conference.. ...................................... vii
APRIL9 , 1958 Dinner Session
Goals of psychotherapy, John C. Whitehorn, M.D. ...................... 1
APRIL1 0, 1958 Morning Session
PROBLEMS OF CONTROLS
Julian B. Rotter, Ph.D., Moderator
Problems of controls in psychotherapy as exemplified by the psychotherapy
research project of the Phipps Psychiatric Clinic, Jerome D. Frank, M.D. 10
The research strategy and tactics of the psychotherapy research project of The
Menninger Foundation and the problem of controls, Lewis L. Robbins,
M.D., and Robert Wallerstein, M.D. ............................ 27
S.
Discussant: John M. Butler, Ph.D. ................................... 44
Group Discussion .............................................. 49
APRIL1 0, 1958 Afternoon Session
METHODS ASSESSMENT OF CHANGE (A)
FOR
Robert A. Cohen, M.D., Moderator
The dimensions and a measure of the process of psychotherapy: a system for
the analysis of the content of clinical evaluations and patient-therapist
.........
verbalizations, Timothy Leury, Ph.D., and Merton Gill, M.D. 62
A tentative scale for the measurement of process in psychotherapy, Carl R.
Rogers, Ph.D. ................................................. 96
Discussant: David Shukow, Ph.D. .................................... 108
Group Discussion ................................................. 116
APRIL 1 1, 1958 Morning Session
METHODS FOR ASSESSMENT OF CHANGE (B)
I. McV. Hunt, Ph.D., Moderator
A technique for studying changes in interview behavior, George Saslow, M.D.,
.................................
and Joseph D. Mutaruzzo, Ph.D. 125
Psychophysiological approaches to the evaluation of psychotherapeutic process
................................
and outcome, John I. Lucey, Ph.D. 160
Discussant: Milton Greenblutt, M.D. .................................. 209
Group Discussion ................................................ 22 1
iv CONTENTS
APRIL1 1, 1958 Afternoon Session
THERAPIST-PATIENT RELATIONSHIP
Benjamin Pasamanick, M.D., Moderator
Page
....................
Inside the therapeutic hour, Edward S. Bordin, Ph.D. 235
Some investigations of relationship in psychotherapy, William U.S nyder, Ph.D. 247
.....................................
Discussant: Maurice Lorr, Ph.D. 260
.................................................
Group Discussion 264
SUMMARY
Research problems in psychotherapy, Morris B. Parlofl, Ph.D., and Eli A.
.............................................
Rubinstein, Ph.D. 276
Preface
The content of this volume represents The recommendation was approved by
the proceedings of a conference held in the Executive Committee of the Division
Washington, D. C., April 9-12, 1958, and an Ad Hoc Committee, consisting of
under the sponsorship of the Division of Drs. Frank Auld, Morris B. Parloff, Ben
Clinical Psychology of the American Pasamanick, Eli A. Rubinstein, George
Psychological Association. Financing for Saslow and Julius Seeman developed
the conference came from a research plans for the conference.
grant from the National Institute of Early in June, 1957 a formal proposal
Mental Health. for financial support of the conference
The idea for this conference was devel- was approved by the Board of Directors
oped in the Spring of 1956 when the of the American Psychological Associa-
Research Committee of the Division of tion and was submitted to the National
Clinical Psychology presented a recom- Institute of Mental Health, which ap-
mendation, based upon a suggestion of proved a grant of for the hold-
$13,685
committee member, Dr. Aaron Nadel, ing of the conference and for publi-
that the Division consider sponsoring a cation of the proceedings. Dr. George
national conference on “objective evalua- Kelly, as President of the Division of
tion of psychotherapy.” It was further Clinical Psychology, served principal
as
recommended that Ad HOCC ommit- investigator, while the original Ad Hoc
an
tee be appointed, composed of both Committee continued as a planning com-
psychiatrists and psychologists, to carry mittee for further organization of the
out the planning necessary to obtain conference.
financial support for the proposed con- In this further development of the
ference and to develop the format for format for the conference the planning
the meeting. committee was much concerned with the
A later and more detailed recom- primary audience which the conference
mendation peinted out that a conference was to serve. Was this to be purely for
of this nature could have multiple bene- the invited guests-a working conference
fits. Most importantly, this conference with an agenda for discussion but no
could afford an opportunity for taking formal presentations? Or were the par-
stock of the present status of research in ticipants to develop material for a much
psychotherapy and thus provide informa- wider audience by preparing formal
tion for and stimulus to further research. papers which would provide the sub-
In addition, the sponsorship of such a stance of a published symposium volume?
national meeting by the Division of The conference ended up a compromise
Clinical Psychology would demonstrate of these two alternate goals, with half
its active interest in this area of research. the time devoted to formal presentations
And, finally, by including representatives and half to group discussions.
of psychology and psychiatry on both Another major consideration was the
the membership of the Ad Hoc Com- focus of the conference. In the original
mittee and among the participants of prospectus it was stated that the general
the conference it was hoped to strengthen aim was to provide a series of presenta-
the research collaboration and interpro- tions and discussions on the broad issues
fessional relations of the two disciplines. in research on the effects of psycho-
vi PREFAC.E
therapy. These were described under Acknowledgment is due Dr. Arthur Hoff-
three major headings: A. Goals of ther- man of the American Psychological As-
apy; B. Measures of change and out- sociation for assistance in the
many
come; C. Problems of controls. As will details necessary to publishing this vol-
be noted from the actual program of the ume. Dr. Roger Russell, Executive Sec-
conference, the scope was broadened retary of the American Psychological
considerably from an emphasis effects Association served as Financial Officer
on
of psychotherapy to include also various for the grant. It is appropriate, not only
aspects of process research. to acknowledge the financial assistance
As indicated in the Table of Contents, of the National Institute of Mental
the conference was organized into four Health, but to express appreciation to
topic sessions, each occupying half a day. Mr. Philip Sapir, Chief, Research Grants
The eight formal papers were all pre- and Fellowship Branch, for his consultive
pared in advance and distributed to the guidance in regard to the grant applica-
conferees before the meeting. The speak- tion.
ers then gave half-hour summaries of It would ordinarily be superfluous and
their papers, with each discussant pre- inappropriate in a volume of this nature
senting a formal discussion paper, also to acknowledge the role of the confer-
prepared advance, in response to the ence participants since the content is
in
two addresses for that topic session. The essentially their own product. However,
last half of the time for each topic was in the preparation of this book, the pro-
devoted to group discussion among all ceedings have been somewhat edited and
participants. There were formal sub- the contributions of some of the partici-
no
group meetings but luncheon and dinner pants are not as apparent as they were at
conversations plus social hours during the conference itself. The moderators of
the two evenings produced the equivalent each of the sessions, Drs. Julian Rotter,
of a number of informal small group Robert A. Cohen, J. McV. Hunt, and
meetings. the evening preceding these Benjamin Pasamanick for the four topic
On
two full days Dr. Whitehorn presented sessions, and Dr. George Saslow for the
his opening address on “Goals of Ther- final morning summary session, each
apy.” And, the last morning following provided the necessary guidance to keep
on
these two days, there was a closing ses- the discussion pertinent and directional.
sion of three hours at which time the An especial acknowledgment is due Drs.
group considered and discussed in turn David Hamburg, Rosalind Dymond Cart-
each of the four topic sessions. Wright, Joseph D. Matarazzo, and Hans
A number of people whose names do Strupp. the last morning, each of
On
not otherwise appear in this volume were these participants provided a summary
helpful in the development of various presentation of one of the topic sessions,
phases of the conference planning. Dr. including their own interpretations of the
James E. Birren of the National Institute themes of that session’s discussion period.
of Mental Health, Dr. Leland Bradford These summary presentations then served
of the National Training Laboratory, and as the basis for the discussion period of
Dr. Jonathan Cole of the National Insti-
the last morning.
tute of Mental Health, provided valuable
suggestions on the administration of vm*- ELI A. RUBINSTEIN
ous phases of the conference format. MORRISB . PARLOFPE, ditors
Participants and Guests of the Conference
on Research in Psychotherapy
CONFERENCPEA RTICIPANTS
FRANBKA RRONV, isiting Professor, Wesleyan JOSEPHD . MATARAZZPOr,o fessor of Medical
University, Middletown, Connecticut Psychology, University of Oregon Medi-
EDWARSD. BORDINP, rofessor of Psychology, cal School, Portland, Oregon
University of Michigan, Ann Arbor, MORRISB . PARLOFFC, hief, Section on Person-
Michigan ality, Laboratory of Psychology, National
Institute of Mental Health, Bethesda,
JOHN M. BUTLER,E xecutive Secretary, The
Maryland
Counseling Center, University of Chicago,
Chicago, Illinois BENJAMINP ASAMANICPrKof, essor of Psy-
chiatry, College of Medicine, The Ohio
DESMONDS. CARTWRIGHATs,s istant Professor
State University, and Director of Re-
of Psychology, University of Chicago,
search, Columbus Psychiatric Institute
Chicago, Illinois
and Hospital, Columbus, Ohio
ROSALINDD YMONCDA RTWRIGHRTes,e arch
LEWISL . ROBBINSC, o-Chairman, Menninger
Associate (Associate Professor), The
Foundation Psychotherapy Research Proj-
Counseling Center, University of Chicago,
ect, Menninger Foundation, Topeka,
Chicago, Illinois
Kansas
ROBERTA . COHEND, irector of Clinical
In- CARLR . ROGERSP, rofessor, Departments of
vestigations, National Institute of Mental
Psychology and Psychiatry, University of
Health, Bethesda, Maryland
Wisconsin, Madison, Wisconsin
ALLEN DITTMANNC, linical Psychologist,
T. JULIANB . ROTTER,D irector, Psychological
Laboratory of Psychology, National In-
Clinic, Ohio State University, Columbus,
stitute of Mental Health, Bethesda, Mary-
Ohio
land
ELI A. RUBINSTEINP,r ogram Analyst, Train-
JEROME D. FRANK,A ssociate Professor of
ing Branch, National Institute of Mental
Psychiatry, Johns Hopkins Medical
Health, Bethesda, Maryland
School, Baltimore, Maryland
GEORGES ASLOWP, rofessor of Psychiatry,
MILTONG REENBLATAT,s sistant Superintend-
University of Oregon Medical School,
ent and Director of Research and Labora-
Portland, Oregon
tories, Massachusetts Mental Health Cen-
JULIUS SEEMANP, rofessor of Psychology,
ter, Boston, Massachusetts
George Peabody College, Nashville, Ten-
DAVIDA . HAMBURGC,h ief, Adult Psychiatry
nessee
Branch, National Institute of Mental
SWKOW, Chief, Laboratory of Psy-
Health, Bethesda, Maryland DAVID
chology, National Institute of Mental
J. McV. HUNT, Professor of Psychology, Health, Bethesda, Maryland
University of Illinois, Urbana, Illinois
WILLIAMU . SNYDERP,r ofessor of Psychology;
GNNES.T ISHAA CSR, esearch Associate, Uni- Director, Psychology Clinic, The Penn-
versity of Illinois, College of Medicine, sylvania State University, University Park,
Chicago, Illinois Pennsylvania
JOHN I. LACEY,C hairman, Department of HANSH . STRUPPD, irector of Psychological
Psychophysiology and Neurophysiology, Services, N. C. Memorial Hospital, Uni-
Fels Research Institute, Antioch College, versity of North Carolina, and Associate
Yellow Springs, Ohio Professor of Psychology in Departments
TIMOTHLYE ARYD, irector, Kaiser Foundation of Psychiatry and Psychology, Chapel
Psychology Research, Oakland, California Hill, North Carolina
MAURICEL ORR,C hief, Neuropsychiatric Re- ROBERTS . WALLERSTEIANs, sociate Director,
search Laboratory, Veterans Benefits Of- Department of Research, Menninger
fice, Washington, D. C. Foundation, and Co-Chairman, Menninger
LESTERL UBORSKYS,e nior Psychologist, Re- Foundation Psychotherapy Research Proj-
search Department, Menninger Founda- ect, Menninger Foundation, Topeka,
tion, Topeka, Kansas Kansas
vii
...
Vlll INVITEDG UESTS
DONALDL. BURHAM, Director of Research, DAVIDM cK. RIOCH,D irector, Division of
Chestnut Research Institute, Rock- Neuropsychiatry, Walter Reed Army In-
Lodge
ville, Maryland stitute of Research, Washington, D. C.
MABEL B. COHEN, Editor, “Psychiatry,”
Training and Supervising Analyst, Wash- W. RUSSELL,E xecutive Secretary,
ROGER
ington Psychoanalytic Society, Inc., Wash- American Psychological Association,
ington, D. C. Washington, D. C.
H. MAX HOUTCHENSC,h ief, Clinical Psy-
chology Division, Psychiatry and New SAPIR,C hief, Research Grants and
PHILIP
rology Service, Department of Medicine Fellowships Branch, National Institute of
and Surgery, Veterans Administration, Mental Health, Bethesda, Maryland
Washington, D. C.
GEORGNE . RAINES,D irector, Department of JOHN c. WHITEHORN, Psychiatnst-inchief,
Psychiatry, Georgetown University Medi- The Johns Hopkins Hospital, Baltimore,
cal School, Washington, D. C. Maryland
Goals of Psychotherapy
JOHN C. WHITEHORNM, .D.
On the eve of a conference in which I did accept the task, and I shall now
we may expect vigorous assertions and proceed to it.
the impact of hard facts upon fondly- First, I can offer the formula: “The
held conceptions, your program commit- goal of psychotherapy is health.”
To
tee has wisely provided this occasion for many, this formula will appear self-evi-
agreeable companionship in the pleasures dent, axiomatic,-indeed, so self-evident
of dining. In breaking bread together we that one runs much risk of looking
have followed a time-honored custom for ridiculous even to consider it a serious
establishing rapport. topic for discussion. Yet some discussion
may be justified, if merely for clarification.
Now your chairman has called upon
me to offer you my thoughts on the topic “Health” is a broad term, of multiple
“Goals of Psychotherapy.” For the pur- meanings. It needs definition and speci-
pose of this conference, this is a central fication. To those in command of a task
-and crucial-topic. Earnest and schol- force of workers, the health of the work-
arly minds are devoting careful thought ers means their ability to work effectively.
to the task of elucidating the processes To the person himself, it means some-
involved in psychotherapy, with much thing more-it means “to enjoy health”
attention to discriminating observation -not merely to function appropriately
and experiment. This conference has and effectively, in work or in play, or in
been called for the purpose of consider- mere existence, but to do so with that
ing concepts and methods for the study inner sense of comfort, pride and satis-
of psychotherapy. For the rational study faction, which may be called the glow
of any human activity it is necessary to of health. Since human beings are un-
know or to postulate the purpose or goal alterably forward-looking, it means also
of that activity. The question, “What is pleasurable expectations of continued
the goal of psychotherapy?’ is therefore competence and satisfaction in function-
the key-question of this conference-the ing. To work good, to feel good, to ex-
key issue from which all other issues pect good-these might be called the
derive their significance. primary dimensions of health. (When I
say good, I mean well.)
You will readily understand, therefore,
If one attempts, for study purposes,
that I felt much complimented when
to construct a scale of health, these
asked by your program committee to
speak on this key issue. Yet I experi- “good” terms seem, however, a bit too
vague. One seeks, and finds, more
enced also some hesitation and indecision
readily scalable positions in the negative
in accepting the invitation; in part be-
cause of my awareness that the inherent directions of these dimensions-in de-
difficulties of this field are compounded grees of disability, in degrees of distress,
by a swarm of aggravating additional dif- in degrees of dread.
ficulties created by professional rivalries I have delineated, thus, very briefly a
and by human propensities to take sides, frame of reference, ’and a statement of
to establish group loyalties, and to the goals of psychotherapy which in my
struggle over whose views shall prevail. judgment has much practical value. The
1