The Use of Structural Analysis of Social Behavior (SASB) as an Assessment Tool

Structural analysis of social behavior (SASB) is a model that can be used to assess interpersonal and intrapsychic interactions in terms of three underlying dimensions: (a) focus (other, self, introject), (b) affiliation-hostility (love-hate), and (c) interdependence-independence (enmeshment-differentiation). Assessment of individuals or groups in terms of these dimensions can be made by self-ratings on the SASB Intrex questionnaires, ratings by others using the same questionnaires, or by objective observer ratings. Data generated by questionnaires or formal codes yield identical summary parameters, making it possible to compare directly objective observer assessments with self-ratings, if desired. The goal of this chapter is to help the reader understand the structure of SASB, become aware of how it has been used in studying interpersonal and intrapsychic events, assess its validity, assess the substance and relevance of criticisms, and consider future possibilities.

Predictors of change after long-term analytic group psychotherapy

In a study of long-term (mean=32.5 months) analytic group psychotherapy we explored the relationships among six predictors shown to influence outcome in short-term group studies and five outcome variables (Global Assessment of Functioning [GAF], Global Symptom Index [GSI], Inventory of Interpersonal Problems-Circumplex [IIP-C], Global Improvement, and Chief Complaints), assessed after termination of therapy. In this study, we wanted to test whether the same variables also predicted patients' status at follow-up, 1 year after termination. Bivariate correlations and multiple regression analyses were used. Initial status and treatment duration up to 2.5 years turned out to be strong positive predictors of status at both time points. Contrary to findings from many short-term studies, presence of personality disorder, high initial severity, chronicity, and less optimistic expectations had no predictive power at either time. Higher age predicted a less favourable status at follow-up in secondary exploratory analyses. The findings suggest that different patients may benefit from long-term versus short-term group psychotherapy. More studies should examine patient aptitude and the significance of the time factor (Aptitude-Treatment Interaction [ATI-effects]).

Psychotherapy and social support: unsettling questions

There is an extensive body of research that documents the importance of social support as an independent factor in physical health and longevity. This article reviews published research that addresses the effects of psychotherapy on social connection and social support. The assumption of most psychotherapists that psychotherapy generally improves social connection is unsupported by research data except in very specific diagnostic categories. Evidence that otherwise beneficial psychotherapy can inadvertently damage social connections is also considered. The implications of these findings for further research and current practice are discussed.

Therapeutic alliance, cohesion and outcome in a long-term analytic group. A preliminary study

We studied the ongoing relationship of patients and their therapist in a long-term, analytic group. The therapeutic alliance was rated weekly and group cohesion was rated every month, by patients and therapist. The patients' symptoms (SCL-90-R) and interpersonal problems (IIP-C) were rated every third month during therapy (self-reports). There was a steady increase in the alliance ratings by patients and therapist during the first 2 years of therapy. This differs from findings in short-term therapies, where the alliance quickly reaches a high level and then remains stable throughout therapy. Therapist ratings of early alliance correlated significantly with positive symptomatic outcome, but did not predict interpersonal change. Patients' alliance ratings did not predict change. Early cohesion ratings did not predict change. The concordance between the patients' and the therapist's alliance ratings was highest between 16 and 30 sessions, and was essentially maintained throughout therapy. An early concordance of patient and therapist alliance ratings predicted a better symptomatic outcome. The measures of therapeutic alliance and cohesion used in this study seem to address different elements in the group process.