Results of a single-case research project to study the connections between therapeutic interventions, the therapeutic relationship and the reflective self-awareness of the patient

The research project examined the psychotherapy process of three patients in long-term psychoanalytic psychotherapy. The therapist's interventions were evaluated in terms of their effectiveness in enhancing mentalization and disconfirming pathogenic beliefs (control mastery theory). Parallel to this, we examined the changes in the patient's reflective self-awareness and the quality of the therapeutic relationship. Using time-series analysis, the authors were able to find a statistically significant connection between the therapist's interventions and the patient's reactions in two out of the three cases. This can be understood as a reciprocal connection: the therapist influences the process of change, but he is not its instigator. In one case they also measured the level of mentalizing capacity at the outset and the end of therapy. The ability to mentalize as such did not improve in the course of therapy but improvement was found in the ability to mentalize in situations of conflict or emotional stress. There was a continuous improvement in the therapeutic relationship in all three patients. However, there was not a parallel improvement in the patients' reflective self-awareness.