Patient Personality and Relational Patterns in Psychotherapy: Factor Structure, Reliability, and Validity of the Psychotherapy Relationship Questionnaire

J Pers Assess. 2018 Jan-Feb;100(1):96-106. doi: 10.1080/00223891.2016.1272050. Epub 2017 Feb 1.

Abstract

The aim of this study was to examine the factor structure and the psychometric properties of the Psychotherapy Relationship Questionnaire (PRQ; Bradley, Heim, & Westen, 2005 ), a clinician report instrument that measures a wide spectrum of thoughts, feelings, motives, conflicts, and behaviors expressed by patients toward their therapists in psychotherapy. A national sample of psychiatrists and clinical psychologists (N = 314) of different theoretical orientations completed the PRQ, as well as the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a , 1999b ) to assess the personality of a patient in their care. Factor-analytic procedures identified 6 transference dimensions that showed excellent internal consistencies: (a) hostile, (b) positive/working alliance, (c) special/entitled, (d) anxious/preoccupied, (e) avoidant/dismissing attachment, and (f) sexualized. Factor scores were significantly related to patients' personality characteristics and psychological functioning, regardless of the clinicians' orientations. The findings support that the PRQ is a valid and reliable tool for evaluating the patients' relational patterns emerging in clinical practice in a clinically coherent and psychometrically robust way. Clinicians' careful understanding of these patterns can be very useful for making accurate diagnostic formulations, as well as for providing a roadmap for effective therapeutic intervention.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Female
  • Humans
  • Male
  • Personality Disorders / diagnosis
  • Personality Disorders / therapy*
  • Personality*
  • Professional-Patient Relations*
  • Psychometrics
  • Psychotherapy / methods*
  • Reproducibility of Results
  • Surveys and Questionnaires / standards*