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Table 3 Examples of Relational Interventions (RI)a

From: Relational interventions in psychotherapy: development of a therapy process rating scale

RI Category 1: The therapist addresses interpersonal transactions with others without any linking to analogous transactions in session.

Therapist

However you will keep up appearances. Pretending that everything is okay with you when you meet him.

RI Category 2: The therapist actively encourages the patient to explore thoughts and feelings about his/her relationships to other (s) including their style and behavior.

Patient

Our children prefer being with my wife. It often seems fine and lively when they are together, while it often becomes awkward when they are with me.

Therapist

How do you feel about that experience?

Patient

It is sad when I think about these situations and what I lose.

RI Category 3: The therapist encourages the patient to discuss how other (s) might feel or think about the patient.

Patient

When I unexpectedly come home to visit a Sunday, my mother would say: “it’s been a long time not seeing you”.

Therapist

Could it be an indication that she is happy? That she misses you more than that she blames you?

Patient

Yes, I think so. She actually is quite supportive. However, I don’t really need to meet my parents as often now. It is more like I meet them when I want to. But if my relationship to my girlfriend ends, I think I would visit my parents. Then I will need some kind of comfort, as I always get there.

RI Category 4: The therapist makes interpretive linking of dynamic elements (conflicts) in the patient’s relationships with other (s)

Patient

He says he is very fond of me and would really like to have a relationship with me.

Therapist

So you are afraid of being let down, that he would lose interest in you when he gets to know you better?

Patient

Mmm mmm (confirms)

Therapist

This fear that people who matter to you would not bother about you. Did you always have this fear or did it come gradually?

Patient

I think I have had this feeling for a long time, as long as I can remember, but I have never really thought about it before.

RI Category 5: The therapist attempts to explore interpersonal repetitive patterns with important other (s) and with parental figures.

Therapist

You say that your boss, in this case, is breaking the regulations. Still you do not confront him, rather you feel like it’s your fault; that you have been leading him to it. You defend your boss and suppress your protest. Could it be helpful for you to see this as sort of an extension of the relationship with your father? When facing your father you did not share your opinions or views, that is, if you assumed that your father did not agree. You were afraid of being rejected and losing your father’s strong support and positive recognition.

Patient

Yes. It is good to bring up my anger against my boss in this matter, because I put the blame on my anger easily and then I experience that he could not have acted in any other way and that it is almost my fault. It is of course not logical, but that is how I feel. Yes, it is a bit like with my father, I never really expressed my disagreement or criticism towards him. So what I feel now is discomfort, like a knot in my stomach, I want to put the whole case aside.

  1. aAll clinical examples are identified in the First Experimental Study of Transference-interpretations (FEST). Written informed consent was obtained from each participant