Treatment Process and Outcomes

We completed two randomized controlled trials (RCT) and a third clinical treatment trial for eating disorders. In the first trial, we demonstrated that Olanzapine, an atypical antipsychotic medication, is useful as a short term intervention to facilitate weight gain in women with Anorexia Nervosa. We also completed an RCT of two types of group psychological therapy for binge eating disorder. Group Psychodynamic Interpersonal Psychotherapy (GPIP), a treatment developed in our Centre, was as effective as Group Cognitive Behavioral Therapy in reducing days binged for women with binge eating disorder (BED). In that trial, high attachment anxiety was associated with better outcomes in GPIP. This led to our third trial that is currently underway in which women with BED are assigned to GPIP groups based on level of attachment anxiety. Finally, we demonstrated the effectiveness of the Intensive Day Hospital Program for Eating Disorders at The Ottawa Hospital. Below is a list of publications for our Treatment Process and Outcomes research theme.

Tasca, G. A., Balfour, L., Presniak, M., & Bissada, H. (in press). Outcomes of specific interpersonal problems for binge eating disorder: Comparing group psychodynamic interpersonal psychotherapy and group cognitive behavioral therapy. International Journal of Group Psychotherapy.

Abstract: We assessed whether an attachment-based treatment, Group Psychodynamic Interpersonal Psychotherapy (GPIP) had a greater impact compared to Group Cognitive Behavioral Therapy (GCBT) on Cold/Distant and Intrusive/Needy interpersonal problems. Ninety five individuals with Binge Eating Disorder (BED) were randomized to GPIP or GCBT and assessed at pre-, post-, and six months post-treatment. Both therapies resulted in a significant decrease in all eight interpersonal problem subscales except the Nonassertive subscale. GPIP resulted in a greater reduction in the Cold/Distant subscale compared to GCBT, but no differences were found for changes in the Intrusive/Needy subscale. GPIP may be most relevant for those with BED who have cold/distant interpersonal problems and attachment avoidance.
Tasca, G. A., Foot, M., Leite, C., Maxwell, H., Balfour, L., & Bissada, H. (in press). Interpersonal processes in group psychodynamic-interpersonal psychotherapy and group cognitive behavioral therapy: A systematic case study of two groups. Psychotherapy.

Abstract: This mixed method systematic case study applied an interpersonal stage model of the therapeutic process to examine interpersonal processes among a highly adherent Group Psychodynamic-Interpersonal Psychotherapy (GPIP) therapist and a highly adherent Group Cognitive Behavioral Therapy (GCBT) therapist and their groups of binge eating disordered (BED) patients. This is the first case study to apply the interpersonal stage model of psychotherapy to compare GCBT and GPIP methods and the first to apply the model to group therapy. Early-, middle-, and late-stage transcribed video recordings of sequential interactions among therapists and patients in each of these two time-limited group therapies were analyzed with the Structural Analysis of Social Behavior (SASB). We also provide qualitative presentations of the transcripts from each stage as context for the quantitative analyses. BED patients in both groups achieved positive outcomes for binge eating and depression. Consistent with their treatment model, the GPIP therapist was more autonomy-giving, whereas the GCBT therapist was more controlling/directive. The GPIP therapist and her group had high levels of interpersonal complementary interaction sequences in the early stage followed by lower complementarity in the middle stage. The GCBT therapist and her group showed a high-low-high pattern of complementarity across the three stage of therapy. However, overall the GPIP group had higher levels complementarity than the GCBT group. This mixed method case study of group processes based on an interpersonal stage model of psychotherapy suggested specific therapist behaviors in each modality to maximize positive therapeutic interactions at each stage of group therapy
Illing, V., Tasca, G., Balfour, L., & Bissada, H. (2011). Attachment dimensions and group climate growth in a sample of women seeking treatment for an eating disorder. Psychiatry: Interpersonal and Biological Processes, 74. 237-251

Abstract: Adult attachment and group process research are emerging areas of research for treating eating disorders. In this study, we examined several aspects of group processes: the weekly growth of group therapy climate, the relationship between group climate growth and outcomes, and the impact of group on individual experiences of group climate. Further, we assessed the relationship between adult attachment dimensions and these group processes. Women (n = 264) diagnosed with an eating disorder completed attachments scales pre-treatment, eating disorder symptom scales pre- and post-treatment, and group climate scales weekly during treatment. Treatment consisted of a specialized eating disorders group-based day hospital program with rolling admissions. Engaged group climate increased and Avoidance group climate decreased across weeks of treatment. Engaged group climate growth was associated with improved eating disorder symptoms post-treatment. Higher attachment avoidance at pre-treatment was related to lower Engaged group climate at week 1, and was related to a greater impact of the group on the individual's experience of group engagement. Clinicians might improve group processes and outcomes by tailoring interventions to individuals' attachment avoidance when treating women for eating disorders.
Tasca, G. A., Maxwell, H., Bone, M., Trinneer, A., Balfour, L., & Bissada, H. (2011). Purging disorder: Psychopathology and treatment outcomes. International Journal of Eating Disorders, Published online, February, 2011

Abstract: Objective: To characterize a tertiary care treatment-seeking sample and assess post-treatment remission and completion rates for purging disorder (PD). Method: Consecutively admitted women with PD (n 5 122), anorexia nervosa (AN) restricting subtype (AN-R; n 5 146), AN binge-purge subtype (AN-B; n 5 154), and bulimia nervosa-purging subtype BN-P; n 5 415) were compared on general and eating disorder specific psychopathology. A subsample (n 5 256) attended a day treatment program and were assessed for post-treatment remission and completion rates. Results: PD occurred in 17.3% of eating disorders not otherwise specified and 6.7% of total eating disorder referrals. PD patients were similar to AN-B and BN-P, but had higher levels than AN-R, on general and eating disorder psychopathology. PD individuals did not have different post-treatment remission or completion rates compared to other eating disorders. Discussion: The results add to a growing literature on the utility of PD as a diagnosis.
Tasca, G. A., Presniak, M. D., Demidenko, N., Balfour, L., Krysanski, V., Trinneer, A., & Bissada, H. (2011). Testing a maintenance model for eating disorders in a tertiary care treatment seeking sample: A structural equation modeling approach. Comprehensive Psychiatry, Published online, February, 2011

Abstract: Fairburn et al (Fairburn, CG, Cooper, Z, Shafran, R. Behav Res Ther 2003;41:509-528) proposed additional maintenance mechanisms (ie, interpersonal difficulties, mood intolerance, low self-esteem, and perfectionism) for some individuals with eating disorders in addition to core eating disorder psychopathology (ie, overevaluation of eating, weight, and shape and their control). This is the first study to both elaborate and test this maintenance model as a structural model. Adults seeking treatment of an eating disorder (N = 1451) at a specialized tertiary care center were included in this cross-sectional study. In the first part of the study, diagnostically heterogeneous participants (n = 406) were randomly selected to test a structural model based on the maintenance model. In the second part of the study, remaining participants (n = 1045) were grouped according to eating disorder diagnosis to test for invariance of the structural paths of the final model across diagnoses. Overall, the structural model with core and additional mechanisms fit the data well and, with 1 exception, represented maintenance processes for each of the diagnostic groups. Treatment models based on both core and additional maintenance factors for those seeking therapy at a specialized tertiary care center may result in improved treatment outcomes for these patients with eating disorders.
Tasca, G. A., Ritchie, K., & Balfour, L. (2011). Practice review: Implications of attachment theory and research for the assessment and treatment of eating disorders. Psychotherapy, Published online, March, 2011

Abstract: In this paper, we review the research literature on attachment and eating disorders and suggest a framework for assessing and treating attachment functioning in patients with an eating disorder. Treatment outcomes for individuals with eating disorders tend to be moderate. Those with attachment associated insecurities are likely to be the least to benefit from current symptom-focused therapies. We describe the common attachment categories (secure, avoidant, anxious), and then describe domains of attachment functioning within each category: affect regulation, interpersonal style, coherence of mind, and reflective functioning. We also note the impact of disorganized mental states related to loss or trauma. Assessing these domains of attachment functioning can guide focused interventions in the psychotherapy of eating disorders. Case examples are presented to illustrate assessment, case formulation, and group psychotherapy of eating disorders that are informed by attachment theory. Tailoring treatments to improve attachment functioning for patients with an eating disorder will likely result in better outcomes for those suffering from these particularly burdensome disorders.
Tasca, G. A., Ramsay, T., Corace, K., Illing, V., Bone, M., Balfour, L., & Bissada, H. (2010). Modeling longitudinal data from a rolling therapy group program with membership turnover: Does group culture affect individual alliance? Group Dynamics, 14, 151-162.

Abstract: Many community- and hospital-based group treatment programs have an open enrolment, that is, a rolling admissions structure, in which a group member who drops out or successfully completes therapy is replaced by another individual. Although practically efficient and perhaps clinically useful, the interdependence of these group participants' data may result in incorrect inferences drawn from the data analyses if this interdependence is not accounted for. We present an analytic strategy that uses time varying covariates in multilevel models to illustrate a methodology to address these data analysis problems. Participants were adults with eating disorders (N _ 229) who attended an average of 12 weeks of a rolling admissions group-based day hospital program during an 8-year period, and who completed a group therapy alliance measure weekly. Individual alliance to the group increased from week to week, and this growth remained significant even after controlling for the time varying level of other group members' alliance to the group. Further, the level of an individual's alliance score during any given week was positively related to the group's alliance during that week. The multilevel time varying covariate models presented here add to a very small but emerging set of analytic strategies available for researchers to address some of the hurdles to correctly analyze data from rolling admissions group-based treatment programs. Results from this study provide evidence that a group's culture is passed on and affects an individual's alliance to the group despite changes in group membership.
Bissada, H., Tasca, G.A., Barber, A., & Bradwejn, J. (2008). A double blind randomized placebo-control trial of olanzapine in the treatment of low body weight and obsessional thinking in women with Anorexia Nervosa. American Journal of Psychiatry, 165, 1281-1288.

Article Title: Olanzapine in the Treatment of Low Body Weight and Obsessive Thinking in Women With Anorexia Nervosa: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Bissada H; Tasca GA; Barber AM; Bradwejn J;
Journal: Am J Psychiatry Volume 165 , Issue10
Date of Publication: 2008 June 16
Abstract: Objective Anorexia nervosa is associated with high mortality, morbidity, and treatment costs. Olanzapine, an atypical antipsychotic, is known to result in weight gain in other patient populations. The objective of this trial was to assess the efficacy of olanzapine in promoting weight gain and in reducing obsessive symptoms among adult women with anorexia nervosa. Method The study was a double-blind, placebo-controlled, 10-week flexible dose trial in which patients with anorexia nervosa (N=34) were randomly assigned to either olanzapine plus day hospital treatment or placebo plus day hospital treatment. Results Compared with placebo, olanzapine resulted in a greater rate of increase in weight, earlier achievement of target body mass index, and a greater rate of decrease in obsessive symptoms. No differences in adverse effects were observed between the two treatment conditions. Conclusions These preliminary results suggest that olanzapine may be safely used in achieving more rapid weight gain and improvement in obsessive symptoms among women with anorexia nervosa. Replication, in the form of a large multicenter trial, is recommended.
Tasca, G.A., Balfour, L., Ritchie, K., & Bissada, H. (2007). Change in attachment anxiety is associated with improved depression among women with Binge Eating Disorder. Psychotherapy, 44, 423-433.

Article Title: Change in Attachment Anxiety is Associated with improved Depression Among Women with Binge Eating Disorder
Authors: Tasca G; Balfour L; Ritchie K; Bissada H;
Journal: Psychotherapy Volume 44, Issue 4
Date of Publication: 2007
Abstract: The study examined if the relationship between change in attachment insecurity and target symptom outcomes was moderated by treatment type. Women (N = 66) with binge eating disorder (BED) were randomly assigned to two treatment types: group cognitive-behavioral therapy (GCBT) or group psychodynamic-interpersonal psychotherapy (GPIP). Results indicated significant positive pre- to posttreatment changes in all attachment insecurity scales, but no difference between GCBT and GPIP on these changes. Change in attachment anxiety was related to improved depression for women completing GPIP, but not for women completing GCBT. This indicated a moderating effect of treatment type in explaining the relationship between change in attachment anxiety and improved depression. Changes in attachment anxiety may be important for symptom outcomes related to psychodynamic-interpersonal therapies. -® 2007 American Psychological Association.
Tasca, G.A., Balfour, L., Ritchie, K., & Bissada, H. (2007). The relationship between attachment scales and group therapy alliance growth differs by treatment type for women with Binge Eating Disorder. Group Dynamics: Theory, Research and Practice, 11, 1-14.

Article Title: The relationship between attachment scales and group therapy alliance growth differs by treatment type for women with binge-eating disorder
Authors: Tasca GA; Balfour L; Ritchie K; Bissada H;
Journal: Group Dynamics Volume 11 , Issue1
Date of Publication: 2007
Abstract: The impact of the treatment context in influencing the relationship between attachment anxiety/avoidance and group therapy alliance growth was examined. Sixty-five women treatment completers with binge-eating disorder received 16 sessions of group cognitive behavioral therapy (GCBT) or group psychodynamic interpersonal psychotherapy (GPIP). Attachment scales were completed before treatment, and a group therapy alliance measure was completed after each therapy session. Growth curve modeling indicated an increasing linear growth in group therapy alliance for both treatments. For GPIP, higher attachment anxiety and lower attachment avoidance were each associated with alliance growth. These relationships were not evident for GCBT. The context of therapy likely activated (in the case of GPIP) or did not activate (in the case of GCBT) defensive attachment strategies. -® 2007 APA, all rights reserved.
Tasca, G.A. & Bone, M. (2007). Individual versus group psychotherapy for eating disorders. International Journal of Group Psychotherapy, 57, 399-403.

Article Title: Individual versus group psychotherapy for eating disorders.
Authors: Tasca, Giorgio A.; Bone, Megan
Journal: International Journal of Group Psychotherapy. Vol 57(3), Jul, 399-403.
Date of Publication: 2007
Abstract: Reviews the books, A comparison of sequenced individual and group psychotherapy for eating disorders not otherwise specified by L. Novonen and A. G. Broberg (2005) and Comparison of group and individual cognitive-behavioral therapy for patients with bulimia nervosa by E. Chen, S.W. Touyz, P. J. V. Beumont, C. G. Fairburn, and R. Griffiths (2003). The study by Novonen and Broberg demonstrated the effectiveness of a sequenced treatment approach for EDNOS that suggests a promising avenue of integrated treatment strategies. Researchers suggest that eating disorder pathology is determined by vulnerability to both negative affect and to dietary restriction. In a second study, Chen and colleagues compared individual versus group-delivered CBT for women suffering from bulimia nervosa (BN). The authors examined whether the two treatment contexts resulted in differential outcomes in disordered eating behaviors, attitudes, and general psychological functioning. Both the studies suggest that group treatment is as effective, and therefore more cost-effective, than individual treatment for eating disorders. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Tasca, G.A., Balfour, L., Ritchie, K., & Bissada, H. (2006). Developmental changes in group climate in two types of group therapy for Binge Eating Disorder: A growth curve analysis . Psychotherapy Research, 16, 499-514.

Article Title: Developmental changes in group climate in two types of group therapy for binge-eating disorder: A growth curve analysis
Authors: Tasca GA; Balfour L; Ritchie K; Bissada H;
Journal: Psychotherapy Research Volume 16 , Issue 4
Date of Publication: 2006
Abstract: The development of group climate across 16 sessions of group psychodynamic-interpersonal psychotherapy (GPIP) and group cognitive-behavioral therapy (GCBT) for 65 female treatment completers with binge-eating disorder (BED) was assessed. Engaged scale growth for GPIP patients varied across sessions and was best represented by a cubic growth curve. This suggested that GPIP progressed in definable phases that reflected a rupture and repair sequence of engaged group climate. For patients receiving GCBT, engaged, avoiding, and conflict scale growth was gradual and consistent (i.e., linear), indicating an increase in positive group climate across sessions. This likely reflected patients taking greater responsibility for treatment as suggested by the CBT model. Linear growth in engaged climate mediated the relationship between attachment anxiety and outcome in GPIP. A consistent increase in engaged group climate through the rupture and repair phase may be a necessary condition for successful treatment of BED patients with high attachment anxiety who receive GPIP. Â© 2006 Society for Psychotherapy Research.
Tasca, G.A., Ritchie, K., Conrad, G., Balfour, L., Gayton, J., Daigle, V., & Bissada, H. (2006). Attachment scales predict outcome in a randomized controlled trial of two group therapies for Binge Eating Disorder: An aptitude by treatment interaction. Psychotherapy Research, 16, 106-121.

Article Title: Attachment scales predict outcome in a randomized controlled trial of two group therapies for binge eating disorder: An aptitude by treatment interaction. [References]
Authors: Tasca GA;Ritchie K; Conrad G; Balfour L; Gayton J; Lybanon V; Bissada H;
Journal: Psychotherapy Research Volume 16, Issue1
Date of Publication: 2006
Abstract: Patients (N =135) with binge eating disorder (BED) were randomized to a control condition or to one of two 16-session group treatments: group cognitive-behavioral therapy (GCBT) or group psychodynamic interpersonal psychotherapy (GPIP). The two treatments performed equally well, and each resulted in reduced days binged compared with the wait-list control condition. Twelve-month follow-up indicated that improvements were maintained in days binged and in other outcome variables. For women who completed GPIP, higher attachment anxiety was related to improvements in days binged by posttreatment. On the other hand, for women who completed GCBT, lower attachment anxiety was associated with improvements in days binged by posttreatment. Higher attachment avoidance was related to dropping out of GCBT. Although both GPIP and GCBT reduced binge eating, the results indicated that individual outcomes differ across treatments based on level of attachment anxiety and avoidance. (PsycINFO Database Record (c) 2006 APA, all rights reserved) (journal abstract.
Tasca, G.A., Mikail, S., & Hewitt, P. (2006). Group psychodynamic interpersonal psychotherapy: Treatment model and outcomes. In M.J. Henri (Ed.), Trends in Depression Research (Ch. 1). New York: Nova Science Publishers.

Title: Group psychodynamic interpersonal psychotherapy: Summary of a treatment model and outcomes for depressive symptoms. Trends in depression research.
Authors: Tasca, Giorgio A.; Mikail, Samuel F.; Hewitt, Paul L.
Book: Henri, Maurice J. (Ed). (2007). Trends in depression research. (pp. 1-30). Hauppauge, NY, US: Nova Science Publishers. x, 173 pp.
Date of Publiation: 2007
Abstract: This chapter presents a summary of a new group therapy approach and a 16-session treatment manual for Group Psychodynamic Interpersonal Psychotherapy (GPIP). The group therapy manual on which this chapter is based (Tasca, Mikail, and Hewitt, 2002) was originally developed as part of a randomized controlled treatment study for Binge Eating Disorder (BED; Tasca, Ritchie, Conrad, Balfour, Gayton, Lybanon, and Bissada, in press). However, the intent of developing the treatment approach was that it be applicable to a wide array of problems including depressive symptoms. For this reason, a broad theory of interpersonal and psychodynamic assessment and diagnosis is presented here, which provides the basis of the GPIP treatment approach. In this chapter depression and depressive symptoms are used as examples of a symptom class that often has a specific cluster of interpersonal problems that underlie the disorder or that co-occur with the disorder. To demonstrate the efficacy of GPIP for the treatment of depressive symptoms, a brief review of outcome data from a randomized clinical trial for the treatment Binge Eating Disorder (BED) is presented. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Tasca, G.A., Mikail, S., & Hewitt, P. (2005). Group psychodynamic interpersonal psychotherapy: Summary of a treatment model and outcomes for depressive symptoms. In M.E. Abelian (Ed.) Focus on Psychotherapy Research (pp.155-188). New York: Nova Science Publishers.

Title: Group Psychodynamic Interpersonal Psychotherapy: Summary of a Treatment Model and Outcomes for Depressive Symptoms. Focus on psychotherapy research.
Authors: Tasca, Giorgio A.; Mikail, Samuel F.; Hewitt, Paul L.
Book: Abelian, M. E. (Ed). (2005). Focus on psychotherapy research. (pp. 159-188). Hauppauge, NY, US: Nova Science Publishers. x, 266 pp.
Date of Publication: 2005
Abstract: This chapter presents a summary of a new group therapy approach and a 16-session treatment manual for Group Psychodynamic Interpersonal Psychotherapy (GPIP). The group therapy manual on which this chapter is based was originally developed as part of a randomized controlled treatment study for Binge Eating Disorder (BED). However, the intent of developing the treatment approach was that it be applicable to a wide array of problems including depressive symptoms. For this reason, a broad theory of interpersonal and psychodynamic assessment and diagnosis is presented here, which provides the basis of the GPIP treatment approach. In this chapter depression and depressive symptoms are used as examples of a symptom class that often has a specific cluster of interpersonal problems that underlie the disorder or that co-occur with the disorder. To demonstrate the efficacy of GPIP for the treatment of depressive symptoms, a brief review of outcome data from a randomized clinical trial for the treatment Binge Eating Disorder (BED) is presented. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Tasca, G.A., Taylor, D., Bissada, H., Ritchie, K., & Balfour, L. (2004). Attachment predicts treatment completion in an eating disorders partial hospital program among women with Anorexia Nervosa. Journal of Personality Assessment, 83, 201-212.

Article Title: Attachment predicts treatment completion in an eating disorders partial hospital program among women with anorexia nervosa
Authors: Tasca GA; Taylor D; Ritchie K; Balfour L;
Journal: Journal of Personality Assessment Volume 83 , Issue3
Date of Publication: 2004 Dec
Abstract: The goal of this study was to examine if attachment theory can provide a framework for understanding treatment completion in an eating disorders partial hospital program among women with anorexia nervosa (AN). Attachment was measured using the Attachment Styles Questionnaire (Feeney, Noller, & Hanrahan, 1994). As hypothesized, self-reports of high avoidant attachment predicted noncompletion of treatment for those with AN binge-purge subtype (ANB). However, this relationship did not emerge for those with AN restricting subtype (ANR). Also as hypothesized, self-reports of high anxious attachment predicted completing treatment for those with ANB but not for those with ANR. For completers with ANB and ANR, the program was helpful in increasing body weight and lowering drive for thinness, body dissatisfaction, interpersonal problems, and depression. Attachment avoidance, characterized by devaluing one's need for relationships, may be a contraindication for group-based partial hospital treatment of ANB. Attachment anxiety, characterized by high preoccupation with relationships, may facilitate remaining in treatment for those with ANB.
Tasca, G.A., Flynn, C.A., & Bissada, H. (2002). Comparison of group climate in an eating disorders partial hospital group and in a psychiatric partial hospital group. International Journal of Group Psychotherapy, 52, 409-417.

Title: Comparison of group climate in an eating disorders partial hospital group and a psychiatric partial hospital group.
Authors: Tasca, Giorgio; Flynn, Carol; Bissada, Hany
Journal Title: International Journal of Group Psychotherapy. Vol 52(3), Jul 2002, 409-417.
Date of Publication: 2002
Abstract: Group climate and related concepts of cohesion and alliance are considered to be key for positive outcome of group psychotherapy. These concepts have rarely been the focus of research done on group therapy within the eating disorders population. This study compares the group climate among patients of two partial hospital programs: one program for an eating disorders population, the other for a mixed psychiatric population. 128 female patients in the eating disorders program and the psychiatric program were compared on a self-report measure of group climate following a psychodynamic-interpersonal therapy group. Those with eating disorders experienced their groups as more engaged and as more avoiding than those in the psychiatric partial hospital group. Therapists may be able to use initial heightened engagement in eating disorder groups to counteract the tendency to avoid content. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Tasca, G.A., Balfour, L., Bissada, H., Busby, K., Conrad, C., Cameron, P., Colletta, S.P., Potvin-Kent, M., Turpin, P. (1999). Treatment completion and outcome in a partial hospitalization program: Interactions among patient variables. Psychotherapy Research, 9, 242-257.

Title: Treatment completion and outcome in a partial hospitalization program: Interactions among patient variables.
Authors: Tasca, Giorgio A.; Balfour, Louise; Bissada, Hany; Busby, Keith; Conrad, Gretchen; Cameron, Paul; Colletta, Salvatore; Potvin-Kent, Monique; Turpin, Pierre
Journal Title: Psychotherapy Research. Vol 9(2), Sum 1999, 232-247.
Date of Publication: 1999
Abstract: Reviews of treatment completion suggest using psychological variables and more complex designs to help predict completion status and understand the relationships among variables. 102 patients (mean age 37.9 yrs) with serious emotional, coping, and interpersonal problems were admitted to a partial hospitalization program. 58 completed the program and 44 terminated prematurely. Psychological mindedness (PM), interpersonal problems, and chronicity of psychiatric problems were used as predictors. A hierarchical logistic regression was conducted. PM and chronicity emerged as statistically significant individual predictors of completion status. Only chronicity increased the odds of classifying completers, while noncompleters were not classified above chance. The interaction between PM and chronicity was statistically significant, but did not increase accurate classification over and above chronicity alone. Completers with more chronic problems had higher levels of PM. PM may act as a buffer against the negative impact of chronicity. It was found that those who completed treatment tended to benefit from treatment. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Tasca, G.A., Russell, V., Busby, K. (1994). Characteristics of patients who choose between two types of group psychotherapy. International Journal of Group Psychotherapy, 44, 499-508.

Title: Characteristics of patients who choose between two types of group psychotherapy.
Authors: Tasca, Giorgio A.; Russell, Vincent; Busby, Keith
Journal Title: International Journal of Group Psychotherapy. Vol 44(4), Oct 1994, 499-508.
Publication Date: 1994
Abstract: Examined the ways in which patient characteristics such as defensive style and psychological mindedness affected the choices of 20 patients between 2 forms of group psychotherapy: a verbally oriented psychotherapy group or a nonverbally oriented activity group. Ss completed the SCL-90 (Revised), the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R), the Psychological Mindedness Assessment Procedure, and the Defense Mechanisms Inventory. Ss who chose the verbal and process-oriented psychotherapy tended to have externalizing defenses, while Ss who chose a structured and activity-oriented group psychotherapy tended to have internalizing defenses; these defenses seem consistent with this group therapy, emphasizing less emotional expressiveness. Psychological mindedness was not related to choice of group psychotherapy. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Tasca, G.A. & McMullen, L.M. (1992). Complementarity and antitheses in a stage model of psychotherapy. Psychotherapy, 29, 515-523.

Title: Interpersonal complementarity and antitheses within a stage model of psychotherapy.
Authors: Tasca, Giorgio A.; McMullen, Linda M.
Journal Title: Psychotherapy: Theory, Research, Practice, Training. Vol 29(4), Win 1992, 515-523.
Publication Date: 1992
Abstract: Studied interpersonal complementarity as an aspect of the therapeutic relationship that changes across the stage model of therapy. Audiotapes of the 1st 20 min of 1 session representing the early, middle, and late stages of 8 cases were transcribed. One successful and 1 unsuccessful case were gleaned from the clients of 4 therapists (3 psychodynamically and 1 experimentally oriented); clients were 8 young adult males. When transcriptions were coded, the stage model of psychotherapy received partial support in that there was a shift in positive complementarity from the early to middle stage for dyads in successful cases. (PsycINFO Database Record (c) 2009 APA, all rights reserved).