Units of observation and perspectives on the psychoanalytic process

Over the past quarter century, brief segments of tape-recorded psychotherapy have become the most widely employed unit for the empirical investigation of the psychotherapeutic process. Our aim was to see how judgements based upon brief segments of tape-recorded psychoanalysis corresponded with judgements based upon the hours from which they were taken. Seven experienced psychoanalysts independently made clinical and quantitative judgements about 29 treatment-related variables on 24 five-minute segments excerpted from psychoanalytic sessions and on the 12 whole sessions from which they were taken. It was found that judgements about the major dimensions of the therapeutic relationship, i.e. transference, based upon segments did not correlate with judgements based upon entire sessions. Judgements based upon segments were less reliable and tended to isolate one participant from another. Judgements based upon sessions were more reliable and captured the basic dimensions of the treatment process, particularly as related to the transference and therapeutic relationship. These findings confirm the results of the only other reported study (Mintz & Luborsky, 1971) in which such comparisons were made and suggest that brief segments cannot be naïvely substituted for entire sessions for the study of the psychotherapeutic process.