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Reliability of Clinical Formulations

Kathryn N. DeWitt, PhD; Nancy B. Kaltreider, MD; Daniel S. Weiss, PhD; Mardi J. Horowitz, MD

Arch Gen Psychiatry. 1983;40(10):1121-1128.

Abstract
• Careful clinical formulation describing the dimensions of core neurotic conflicts is integral to the practice of psychodynamic psychotherapy. Therefore, a method for reliable and valid formulation is a necessary precursor for the empirical investigation of the impact of such therapy. Our study evaluated a method of outcome assessment based on clinical formulations. Results from 18 patients indicate that independently derived formulations of a central conflict do not agree and that these disagreements in formulation are reflected in disagreements in the change ratings that are based on them. Additional analyses suggested that symptomatic change represents the major component in outcome rating.

Author Affiliations
From the Center for the Study of Neuroses, Langley Porter Psychiatric Institute, San Francisco.

Footnotes
Accepted for publication July 28, 1982.

Read in part at the annual meeting of the Society for Psychotherapy Research, Asilomar, Calif, June 20, 1980.

Reprint requests to Langley Porter Psychiatric Institute, 401 Parnassus, San Francisco, CA 94143 (Dr DeWitt).

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