Psychotherapeutic relationship and outcome in psychotherapy of personality disorders

The study examines the predictive significance we of the quality of the individual therapeutic relationship for outcome in patients with personality disorders who underwent inpatient psychodynamic psychotherapy. In a prospective study 254 patients with DSM IV Cluster B and C personality disorders were examined at several intervals in the course of inpatient psychotherapy with the Helping Alliance Questionnaire, the Symptom Check List SCL-90-R, the score for severity of impairment and with questionnaires on the form of therapy for patients and therapists. Independent of the outcome, patients classified individual psychotherapy as the most effective form of therapy. Successful patients also favoured group psychotherapy as being particularly effective; unsuccessful patients rated group psychotherapy as poor. Test results from patients in the dimensions therapeutic alliance and relationship in the Helping Alliance Questionnaire correlated significantly with the outcome of the therapy after just two weeks. The investigation supports a central role of the individual therapeutic relationship for the outcome of therapy in inpatient psychotherapy for personality disorders. The Helping Alliance Questionnaire is suitable for an effective monitoring of the inpatient therapy process.