The effects of social cognition and object representation on psychotherapy continuation

This study investigates the extent to which the number of psychotherapy sessions attended is predicted by the Rorschach Mutuality of Autonomy Scale (MOA; Urist, 1977), Holt primary (A1) and secondary (A2) process aggression variables (Holt, 1977), and ratings of Thematic Apperception Test (TAT) narratives using Westen's (1995) eight Social Cognition and Object Relations Scale (SCORS) variables (complexity of representation of people, affective quality of representations, emotional investment in relationships, emotional investment in values and moral standards, understanding of social causality, experience and management of aggressive impulses, self-esteem, identity and coherence of self). Seventy-six patients with a DSM-IV Axis II diagnosis participated in this study. Two separate stepwise regression analyses (one for Rorschach variables, N = 76, and one for the SCORS ([TAT]) variables, n = 63) indicated that the Rorschach MOA PATH score (sum of scale points 5, 6, and 7; positive), as well as two individual SCORS variables (in order of relative magnitude, affective quality of representations, negative, and emotional investment in relationships, positive), were predictive of the number of psychotherapy sessions attended by patients. The conceptual nature and clinical utility of these variables are discussed in relation to the termination and continuation of psychodynamic psychotherapy.