[Empirical study of inpatients viewed from the individual psychotherapy]

There are very few empirical studies which address the effect of psychotherapy in inpatient settings. The author extracted 45 inpatient cases which could withstand detailed statistical analysis among patients who had been admitted to the psychiatric ward of the Tokai University Hospital between 1975 and 1981. Therapists of the cases were interviewed individually and the cases were evaluated retrospectively based on the criteria proposed by the study of Menninger Foundation. Significant statistical improvements were found on every items of evaluation. Furthermore, patients who had shown good interpersonal relationships and motivation at the time of admission showed positive conditions at the time of discharge. Factor analysis of therapeutic variables yielded five factors which delineated the following characteristics of the therapists: 1) having a psychoanalytic orientation, 2) viewing the improvement of symptoms as the goal of therapy, 3) utilizing one's experiences and skills, 4) utilizing a supportive approach, and 5) giving careful attention to the structuring of the psychotherapy sessions. As for the situational variables of the patients, factor analysis yielded only one factor, and multiple regression analysis revealed no significant therapeutic effects. Two types of multiple regression analysis were conducted to determine therapeutic effects and therapeutic variables, but no significant factors were found. Thus, the cases were classified into five groups according to interpersonal relationships factors and were analyzed according to "quantification method II" (Hayashi, C.). The following results were obtained: 1) the structuring of inpatient therapy should correspond with the patient's level of responsibility, 2) as for the structure of psychotherapy, the quality of improvement depended on the closeness to the psychoanalytic structure, i.e., the closer to the psychoanalytic structure, the higher the improvement, 3) the quality of improvement was poor when transference issues (in the sessions) were not brought up during the psychotherapy sessions, 4) the quality of improvement rose according to the degree that dreams and fantasies were dealt with, 5) hospital admission periods of 101 to 120 days showed the highest of improvement, 6) the frequency of sessions did not determine the quality of improvement, 7) the personality of therapist had strong effects when it worked in a negative way, and 8) the quality of improvement corresponded to the degree of the permissive atmosphere in the therapeutic relationship.