Therapeutic Change in Clinical Case Reports and on the Rorschach

  • Sidney J. Blatt
  • Richard Q. Ford
Part of the Applied Clinical Psychology book series (NSSB)


This chapter will consider the evaluation of therapeutic change as expressed in ratings of clinical behavior described in the clinical case reports prepared on each patient after the first 6 weeks of hospitalization and then again, on average, after 15 months of intensive treatment including psychoanalytically oriented individual psychotherapy four times weekly. The case records were rated for manifest clinical symptoms of psychosis, neurosis, and labile and flattened affect, as well as for the quality of social interactions with other patients and members of the clinical staff. In addition, Rorschach protocols administered at these same two times in the treatment process were independently evaluated for a variety of dimensions including thought disorder and the quality of the representation of the human figure and the nature of its interactions.


Case Record Object Relation Psychological Test Therapeutic Change Thought Disorder 
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  1. 1.
    Standard deviations of all measures derived from clinical case records and psychological test protocols at Time 1 and Time 2 are presented in Appendix 10.Google Scholar
  2. 2.
    Mean scores were used for the Goldstein and Zigler-Phillips measures of premorbid adjustment rather than the more usual sum scores because on occasion the case records lacked the information necessary to rate one of the variables included in these two measures of premorbid adjustment. Thus, mean scores were derived for both measures of premorbid adjustment to reflect the average premorbid level for those variables of the scales for which there was adequate information to make these ratings.Google Scholar
  3. 3.
    Data analyses of the stories told to the Thematic Apperception Test were not included in this chapter and are presented separately because prior research indicated that there are significant sex differences between females and males in their use of the three types of defense in TAT stories, thus requiring more detailed statistical analyses of the interaction between sex, anaclitic-introjective patients, and types of defenses. Data analyses of the human figure drawings are also reserved for a later chapter because the number of patients who had been given this procedure was substantially less than the data available from the Rorschach and the ratings of the clinical case records.Google Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Sidney J. Blatt
    • 1
  • Richard Q. Ford
    • 2
  1. 1.Yale UniversityNew HavenUSA
  2. 2.Austen Riggs Center, Inc.StockbridgeUSA

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