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The panel discussion was opened with a presentation by Joseph O. Chassell. By an empirical study of a sampling of cases, illustrating a variety of treatment plans, he attempted to draw some conclusions as to the dynamics of therapy, and the essential conditions for therapy. With the hypothesis that the need for a certain type of therapeutic relationship is the touchstone, he proceeded to a consideration of how to go about recognizing and anticipating types of relationship need, how to classify patients from this point of view, and what suggestions to offer about treatment approaches.
Chassel attempted to identify some significantly different treatment types, not in classical analysis, and where something genuinely therapeutic took place. Ten inpatients in intensive therapy, and ten outpatients seen on a once-a-week basis, were studied. The following questions were asked in each instance:
1What was the treatment plan and what became of it?
2Who was responsible for the choice of actual treatment?
3What really happened therapeutically?
In his discussion Chassell endeavored to phrase his observations and his hypotheses in other than psychoanalytic terms in order to promote freshness of perception and rethinking of concepts. He stated that in the interpersonal relation called psychotherapy, the therapist aims at becoming an auxiliary ego to the patient's, introjected as friendly. After initial valuation, true therapy probably needs some personal commitment on the part of the therapist.
In Chassell's cases where something constructive happened he found that some engagement did take place, following the therapist's ability to respond positively to the patient's expression of need. In those cases where no change took place, it seemed that while the patient expressed need for some kind of relationship the therapist had not evaluated it properly because of conviction as to the treatment plan he should follow, or for some other reasons.
Chassell felt that there was a need for