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Therapist Perceptions of Process in Psychodynamic Therapy Treating Compulsive Sexual Behavior Disorder and Comorbid Borderline Personality Disorder.

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Bibliographic Details
Title: Therapist Perceptions of Process in Psychodynamic Therapy Treating Compulsive Sexual Behavior Disorder and Comorbid Borderline Personality Disorder.
Authors: Goodman, Geoff (AUTHOR), Clark, Adam (AUTHOR), Chung, Hyewon (AUTHOR)
Source: Sexual Health & Compulsivity. Apr-Jun2026, Vol. 33 Issue 2, p185-204. 20p.
Subjects: Psychodynamic psychotherapy, Compulsive behavior, Psychotherapist attitudes, Human sexuality, Questionnaires, Time series analysis, Sex customs, Borderline personality disorder, Case studies, Data analysis software, Physical therapy students
Abstract: This study examined the relations between therapist perceptions of psychodynamic therapy (PDT) process, adherence to PDT principles, and interaction structures formed between therapist and patient. A graduate student therapist treated a 28-year-old man diagnosed with compulsive sexual behavior disorder and borderline personality disorder with PDT (N = 52 sessions). Following each session, the therapist completed the Psychotherapy Process Q-Set (PQS) to capture his perceptions of session process. Independent coders completed the PQS from session audio-recordings. Preceding each session, the patient completed the Outcome Questionnaire to measure psychological distress. The therapist was most discrepant on items pertaining to his own attitudes and behavior (including interventions), indicating countertransference. Therapist agreement with the independent coders was positively correlated with PDT session adherence and negatively correlated with untherapeutic interaction structures (i.e. reciprocal patterns of interaction) identified in a previous study. Simulation modeling analysis revealed that increased therapist agreement and psychological distress independently preceded increases in a potentially therapeutic interaction structure observed one session later. Therapist agreement was associated with PDT session adherence and interaction structures, suggesting routine monitoring to protect treatment fidelity and therapeutic interaction structures. KEY PRACTITIONER MESSAGE: Therapists sometimes misperceive what they say and do in therapy, potentially denying their infidelity to their therapeutic principles and denying disruptions to the quality of relationships they form with their patients. Therapists must monitor their need to perceive themselves as maintaining perfect allegiance to their therapeutic principles and perfect relationships with their patients. A lack of awareness of these needs can make their patients feel misunderstood. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:This study examined the relations between therapist perceptions of psychodynamic therapy (PDT) process, adherence to PDT principles, and interaction structures formed between therapist and patient. A graduate student therapist treated a 28-year-old man diagnosed with compulsive sexual behavior disorder and borderline personality disorder with PDT (N = 52 sessions). Following each session, the therapist completed the Psychotherapy Process Q-Set (PQS) to capture his perceptions of session process. Independent coders completed the PQS from session audio-recordings. Preceding each session, the patient completed the Outcome Questionnaire to measure psychological distress. The therapist was most discrepant on items pertaining to his own attitudes and behavior (including interventions), indicating countertransference. Therapist agreement with the independent coders was positively correlated with PDT session adherence and negatively correlated with untherapeutic interaction structures (i.e. reciprocal patterns of interaction) identified in a previous study. Simulation modeling analysis revealed that increased therapist agreement and psychological distress independently preceded increases in a potentially therapeutic interaction structure observed one session later. Therapist agreement was associated with PDT session adherence and interaction structures, suggesting routine monitoring to protect treatment fidelity and therapeutic interaction structures. KEY PRACTITIONER MESSAGE: Therapists sometimes misperceive what they say and do in therapy, potentially denying their infidelity to their therapeutic principles and denying disruptions to the quality of relationships they form with their patients. Therapists must monitor their need to perceive themselves as maintaining perfect allegiance to their therapeutic principles and perfect relationships with their patients. A lack of awareness of these needs can make their patients feel misunderstood. [ABSTRACT FROM AUTHOR]
ISSN:26929953
DOI:10.1080/26929953.2026.2623014