Testing of the therapist to reduce maladaptive interactional patterns: Categorizing patients' tests

This empirical study undertakes a categorization of the core concept of Control Mastery Theory: mostly unconscious testing of pathogenic beliefs that patients exhibit in relating to their therapist to work on their problems. The focus lays on latent meanings of manifest tests.

We qualitatively analyze transcripts of 172 psychotherapy sessions with 23 patients for sequences in which significant patient-therapist interactions occur, and systematize identified tests into thematic categories based on what tests intent to achieve (ICC = .68). Guided by theory, the analysis is attending to complexity, individuality, and the unconscious.

Tests circle around striving for independence, deserving/self-worth, acceptance, and entitlement. Individual tests have various underlying meanings, are interrelated, and may be multidimensional.

Meanings of tests must be confirmed within the psychotherapeutic process. Incorporating the treating clinician thus seems important.