Change in self-protect ion and symptoms after dynamic psychotherapy: the influence of pretreatment motivation.
An instrumental for rating patients as suitable (I) or not suitable (NI) for insight-oriented psychotherapy, is described. It is based on factors suggested by Dewald, and consists of 24 scales, each with 5 steps. Inter-rater reliability was greater than 0.60 in 11 of the scales in a study of 25 cases, and four subscales were significantly correlated to suitability for insight-oriented psychotherapy according to the total scale: "influence of environmental factors on the symptoms", "variability of the symptoms during the last year", "self-confidence", and "possibility to psychodynamic formulation with circumscribed focus". Construct validity was estimated by comparing 29 pairs of I and NI patients. I patients belonged to a higher social class, scored higher on the personality trait dominance and low on neuroticism, had a more positive experience of the therapist, had lower symptom intensities, and were given a lower global rating of the disorder. I patients were more improved than NI patients when given unspecific treatments. The differences were, however, small. Predictive validity in 38 patients was low which may be due to the fact that the rater had to consider the research points of view, the global nature of several variables and the course criteria for correct allocation.