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.
Psychotherapy research can be divided into 4 generations, marked by increasing conceptual sophistication and technological enhancement. The 1st generation (1917-1968) comprised simple retrospective counts of improved outcomes by unspecified criteria. The 2nd generation (1959-1985) consisted of 2 kinds: (a) prospective group-aggregated studies of psychoanalytic treatments, with specified definitions, operationalized criteria, and predictions to expected outcomes, and (b) individually studied outcomes in a sequence of patients. The 3rd generation (1954-1986) combined both kinds of 2nd-generation studies with the added feature of separating outcomes at termination from the more enduring effects at subsequent follow-up. The 4th, current generation (1970s-) adds in micro-analytic process studies made possible by recent technological advances—audiotapes, combined with computer searches.
Robert S. Wallerstein, MD, San Francisco Psychoanalytic Institute, San Francisco, California, and University of California, San Francisco, School of Medicine.
This article was presented in slightly altered form as the Friday evening plenary lecture, Rapaport–Klein Study Group meeting at Austen Riggs Center, Stockbridge, Massachusetts, June 11, 1999, and as the plenary lecture at Section 6, Division 39, San Francisco, April 2000.
Correspondence concerning this article should be addressed to Robert S. Wallerstein, MD, 290 Beach Road, Belvedere, California 94920. Electronic mail may be sent to
Programs are currently being fashioned to combine these ongoing process studies with the best outcome measures in order to realize the principle of Patient-Treatment-Outcome Congruence, the representation of the patient's illness, the treatment process, and assessed outcome in comparable terms.