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Michigan Psychoanalytic Institute & Society

Porcerelli Wins APsaA Research Award

John Porcerelli, Ph.D. has received a Career Research Award grant from APsaA to study three types of psychotherapy processes within interpersonal psychotherapy for postpartum depression. His collaborators on the study are Scott Stuart, M.D. (University of Iowa Medical School) and Stuart Ablon, Ph.D. (Harvard Medical School).

Dr. Porcerelli's study builds upon two recent studies of psychotherapy process. The first was conducted by Ablon & Jones (1998). They developed ideal prototypes of psychodynamic and cognitive behavioral treatments (CBT) and compared them in successful treatments. Ablon and Jones developed a therapy process instrument--the Psychotherapy Q-Set (PQS)--to assess what goes on in psychotherapy and psychoanalysis between therapist and patient. They applied the PQS to sessions of CBT and psychodynamic therapy. By comparing the actual process of psychotherapy sessions with the CBT and psychodynamic prototypes, they were able to empirically identify how much each treatment used techniques from both schools of therapy. Their findings were quite surprising. They discovered that psychodynamic therapists used both psychodynamic techniques and cognitive behavioral techniques and CBT therapists used a lot of CBT technique and very little psychodynamic technique. However, it was the psychodynamic techniques within both treatments that were associated with positive outcome!

In a second study, Ablon & Jones (2002) used their methodology for developing prototypes from the PQS to test the effects of interpersonal therapy (IPT) and CBT technique on therapy outcome using data (PQS-coded therapy sessions) from the NIMH Treatment of Depression Collaborative Research Program (TDCRP; Elkin et al., 1989). IPT and CBT were the (manualized) psychotherapy treatment groups within the TDCRP. When the CBT and IPT processes were assessed in each treatment, it was discovered that CBT technique was used a great deal by both CBT and IPT therapists. In addition, CBT technique was strongly associated with positive outcome in both therapies.

The work of Jones & Ablon (1993) and Ablon & Jones (1998, 1999, 2002) has demonstrated the association between prototypes of three therapies (psychodynamic, IPT, and CBT) with therapy outcome. In their 1998 study, Ablon & Jones reported the surprising finding that adherence to the psychodynamic prototype in both psychodynamic and CBT was robustly associated with therapy outcome and that adherence to the CBT prototype was not associated with therapy outcome for either treatment. In the 2002 study, Ablon & Jones reported the surprising finding that IPT and CBT were both strongly associated with the CBT prototype and adherence was strongly associated with therapy outcome. These results set the stage for Porcerelli's study. By using an already completed (and successful) study of IPT treatment for postpartum major depression (conducted by Stuart & O'Hara at U of Iowa), Porcerelli and his collaborators will assess the degree to which therapists in that study used psychodynamic, IPT, and CBT technique and which techniques were associated with positive outcome.