You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The Therapist-Patient Interaction Rating Scale instrument (TPIRS) is derived from Kernberg's Transference Focused Psychotherapy (TFP) for treating Borderline Personality Organizations (BPO) (Kernberg 1984). With the transference interpretation as the key intervention, the main objective of treatment is to integrate and consolidate the personality structure of the subject (Kernberg 1984). Emphasis is placed on ego functioning, reality testing, sense of identity, and defensive mechanisms, all which can be evaluated via the subject's verbal and nonverbal language during the therapy sessions. Because these elements are worked with and constantly evaluated in each session throughout the different stages of treatment, the clinician's experience is important when learning and utilizing TFP.
The TPIRS is a dual-scale instrument that dynamically (minute by minute) rates therapist interventions and patient responses on a 0-5 scale (Cassab 2004; Clarkin, Yeomans, and Kernberg 1999). As can be seen in Table 1, listing therapist interventions, the instrument includes detailed working definitions of these interventions.
This allows the rater to look for specific interventions as they happen. The scale moves from silence to more structured interventions and on to more abstract and elaborate interventions.
The second perspective in this instrument, patient responses, presents a series of observable dynamics noticeable in the patient according to the realm of response. Behaviors as such are assumed to reflect underlying intrapsychic defense mechanisms, which may be inferred (see Table 2)
The objectives of our instrument development and preliminary reliability study were (1) to create an instrument simultaneously rating therapist interventions and patient responses as they occur in real time throughout a TFP treatment; and (2) to test the reliability of the instrument by making it accessible to other researchers for them to apply with their own subjects and with therapeutic modalities ot