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The concept of transference and the therapeutic benefit of insight are central postulates of the psychoanalytic method. In a recent Journal of Counseling and Clinical Psychology article, Johansson et al. tested the hypothesis that insight is the mechanism behind the long-term effects of transference interpretation. The authors argued that focusing on transference issues between patient and therapist leads to an increased capacity to reflect on and understand interpersonal problems, which in turn leads to an improvement in interpersonal functioning and treatment outcome. The authors further argued that patients with well-developed interpersonal skills and insight into social relations might benefit more from this approach than patients who are less developed in these areas of functioning.
To test this hypothesis, the authors conducted a dismantling, randomized controlled trial among 122 patients with depressive disorders, anxiety disorders, personality disorders, and interpersonal problems. Patients were randomly assigned to a year of weekly psychodynamic therapy with either moderate levels of transference interpretation or no transference interpretation. Based on above or below average scores on the Quality of Object Relations scale, patients were considered to have either high or low pretreatment interpersonal skills, respectively. Change in interpersonal functioning was assessed with the Psychodynamic Functioning Scale at pre-treatment, post-treatment, one-year, and three-year follow-up intervals.