An empirical investigation of analytic process: contrasting a good and poor outcome case

The aim of this article is to assess the difference in the analytic processes between two patients with similar personality profiles, who were in analysis during the same time, by two analysts with similar training and working in a similar setting. We explored patients' personality and changes with the Global Assessment of Functioning Scale (GAF; APA, 2000) and the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) applied by two pairs of independent raters in 16 sessions. In addition, we assessed therapeutic processes with the Analytic Process Scales (APS; Waldron, Scharf, Hurst, Firestein, & Burton, 2004b) and the Dynamic Interaction Scales (DIS; Waldron, Gazzillo, Genova, Lingiardi, 2013) applied by three independent raters to 20 sessions, as well as the Helping Alliance Rating Scale (HAR; Luborsky, Crits-Cristoph, Alexander, Margolis, & Cohen, 1983) applied to eight sessions from the beginning of each therapy. Our results showed striking differences between the outcomes of these two psychoanalyses that are paralleled by differences in their therapeutic process. We provide verbatim clinical interactions to illustrate these differences and explore the potential implications of these findings.