THERAPEUTIC COMPONENTS OF PSYCHOTHERAPY

Abstract

This paper summarizes the experiments of the Johns Hopkins Psychotherapy Research Unit on brief psychotherapy of psychiatric outpatients. Major findings were that the beneficial results of psychotherapy include two components, activation of patients' expectations and learning of social skills; that psychiatric outpatients showed a marked decrease of symptoms in response to placebos, the degree of response depending on the interaction between the patient's momentary state at a particular time and the situation; that an interview preparing patients for therapy led to more appropriate behavior in therapy and greater clinical improvement; that emotional arousal by inhalation of ether or adrenalin increases attitude change in response to the therapist's suggestions; that therapeutic improvement which the patient attributes to his own efforts is more enduring than that attributed to a pill; and that there is a significant interaction between whether a patient sees himself as controlled by or in control of his environment and his response to these therapeutic conditions. Data are summarized concerning factors related to remaining in treatment and to short term improvement. Aspects of the long term course of psychiatric outpatients revealed by 5-and 10-year follow-up studies are reviewed.

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