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Forty-Two Lives in Treatment by Robert Wallerstein gives a comprehensive summary of the Psychotherapy Research Project (PRP) of the Menninger Foundation, started in the early 1950s in Topeka, Kansas. It sought originally to answer two basic questions: (1) What changes occur in psychotherapy and what good does psychotherapy do? and (2) How do these changes come about? Now it is some 30 years later with over one million dollars having been spent on the PRP and the examination of its findings. Wallerstein's 750-page book focuses upon psychological treatment and how it has affected the lives of 42 PRP patients. These 42 patients, evenly divided in gender, were initially given a comprehensive two-week psychological evaluation at the Menninger Foundation between 1954 and 1958. Recommended from the evaluation was that 22 of the patients be referred for psychoanalysis while 20 were referred for psychotherapy.
Bob Wallerstein, the principal investigator of the PRP, is a distinguished psychoanalyst who is currently President of the International Psycho-Analytic Association. Bob was one year ahead of me as a psychiatric resident in Topeka. He was always admired for his hard work, integrity and creativity. He has done a Herculean job in going over all of the psychological data in the PRP. Despite all this data, there are some built-in limitations to the findings, and I even doubt if the two original questions have been fully answered.
What has been well documented is the long-term result from each of two treatment modalities on the lives of 42 patients. All were private patients who had come to Topeka because they had not found the psychiatric treatment they needed at home. Their comprehensive psychological evaluation included 10 interview hours with a psychiatrist and a full battery of psychological tests. They were accompanied by another adult who was interviewed about the patient by a psychiatric social worker. At the final case conference the recommended treatment modality is