This study investigated the predictive utility of assessing clients' object relations functioning to prognosticate therapy dropout, quality of the early working alliance and psychotherapy process events reported by clients after their first five sessions. Clients accepting a recruitment invitation were administered the thematic apperception test (TAT) shortly after intake, and those still in treatment three to four sessions later rated the working alliance and psychotherapy process events. Participants were 47 clients beginning psychotherapy with advanced doctoral practicum students at a university-based community-serving training clinic. The Social Cognition and Object Relations Scales (SCORS), an object relations scoring system for TAT stories, was used to assess object relations functioning. The California Psychotherapy Alliance Scales—Patient form measured four dimensions of the alliance. The Therapy Orientation Process Scales, created from the Psychotherapy Process Q-set, measured clients' perceptions of therapy process events as involving relatively more psychodynamic or cognitive behavioural techniques. The SCORS significantly predicted remaining in therapy, client ratings of stronger working alliance and typical therapy process as more psychodynamic than cognitive behavioural. SCORS complexity of representations and capacity for emotional investment in relationships scales were the strongest predictors, especially of the patient commitment facet of the alliance. The findings suggest that (1) beginning psychotherapy with object relations assessment can be useful for treatment planning and (2) the relationship between clients' object relations functioning, working alliance and greater sensitivity to psychodynamic than to cognitive behavioural interventions depends on the aspect of object relations that is being assessed.

中文翻译：

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客体关系评估预测门诊患者流失、早期工作联盟和心理治疗过程

本研究调查了评估来访者的客体关系对预测治疗退出、早期工作联盟的质量和来访者在前五次治疗后报告的心理治疗过程事件的预测效用。接受招聘邀请的客户在入职后不久接受主题统觉测试（TAT），仍在接受治疗的客户在三到四次会议后对工作联盟和心理治疗过程事件进行评分。参与者是 47 位客户，他们在一家大学社区服务培训诊所与高级博士生一起开始心理治疗。社会认知和对象关系量表 (SCORS) 是一种用于 TAT 故事的对象关系评分系统，用于评估对象关系的功能。加州心理治疗联盟量表——患者表测量了联盟的四个维度。由心理治疗过程 Q-set 创建的治疗取向过程量表测量客户对治疗过程事件的看法，因为它涉及相对较多的心理动力学或认知行为技术。SCORS 显着预测留在治疗中，更强大的工作联盟的客户评级和典型的治疗过程比认知行为更具心理动力学。SCORS 表征的复杂性和情感投入的能力是最强的预测因素，尤其是联盟的患者承诺方面。