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Schachter, J. Martin, G.C. (1993). Stability of Gains Achieved During Analytic Treatment from a Followup Perspective. J. Amer. Psychoanal. Assn., 41:209-217.

(1993). Journal of the American Psychoanalytic Association, 41:209-217

Stability of Gains Achieved During Analytic Treatment from a Followup Perspective

Joseph Schachter, M.D. and Gary C. Martin, M.D.

THE PANEL WAS INTRODUCED BY Schachter who quoted Freud to the effect that we have no means of predicting what will happen later to a patient who has been cured. Schachter added that we need to determine the stability of gains achieved during analysis.

After reviewing some of the research on psychoanalytic outcomes, he concluded that only two—the Menninger study and the Boston study—met the stringent criteria which included a prospective design, an assessment of process and outcome, an evaluation by someone other than the treating analyst, a gauging of the reliability of the assessments, and an examination of outcome based on followup. Schachter noted that although both studies showed a similar percentage of post-termination improvement (about 40%), they were contradictory in their findings of the relation between the degree of improvement during treatment and the post-termination course. Whereas the Menninger study found a positive correlation between the degree or lack of improvement or regression in analysis and the post-termination course, the Boston study found that neither the analyst's nor the patient's assessments, nor the psychological tests at termination, could predict who would improve or retain psychological change in subsequent years.

Schachter asked what factors could play a role in the different results regarding the stability of analytic gains. He noted that L. Luborsky had found that patients with a deficient capacity for internalization are most likely to show a loss of analytic gains over time. He also hypothesized that the patient's expectation during treatment of post-termination contact seems to positively influence the stability of gains.

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