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Psychodynamic formulation, consensual response method, and interpersonal problems.

L M Horowitz, S E Rosenberg, G Ureño

    Journal of Consulting and Clinical Psychology
    |October 1, 1989
    PubMed
    Summary
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    This study introduces a novel method for combining psychodynamic formulations from multiple clinicians, improving the prediction of patient interpersonal problems during therapy. The consensual approach enhances the accuracy of identifying key issues for effective treatment planning.

    Area of Science:

    • Psychology
    • Psychiatry
    • Clinical Psychology

    Background:

    • Psychodynamic formulations are crucial for understanding patient issues in therapy.
    • Standardizing these formulations across clinicians presents a challenge.
    • Brief dynamic psychotherapy relies on accurate initial assessments.

    Observation:

    • 15 patients underwent pre-therapy interviews observed by clinician panels.
    • Individual psychodynamic formulations were generated by 8 clinicians per patient.
    • Formulations were text-analyzed into thought-units for aggregation.

    Findings:

    • A novel method aggregated individual formulations into a consensual formulation.
    • Consensual formulations accurately predicted interpersonal problems discussed in therapy.

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  • High interpersonal content in formulations correlated with better prediction accuracy.

    • Implications:

    • This method offers a reliable way to synthesize expert clinical judgment.
    • Improved formulation accuracy can lead to more effective and targeted psychodynamic treatments.
    • The approach has potential applications in clinical training and research for consensus-building.