Rorschach and MMPI-2 indices of early psychotherapy termination.
Abstract
This study was an investigation of the differences between 97 patients who had prematurely terminated psychotherapy (M = 1 session) and 81 who had participated in individual psychotherapy for at least 6 months and 24 sessions (M = 18 months/72 sessions) on selected Minnesota Multiphasic Personality Inventory--2 (MMPI-2) and Rorschach variables. None of the between-group comparisons using the MMPI-2 proved to be significant. However, a multivariate analysis of variance of 9 Rorschach variables in 3 conceptual categories--(a) interpersonal relatedness, (b) psychological resources versus resource demand, and (c) level of psychopathology--proved to be significant at p = .008. The Rorschach scores from the interpersonal-relational category proved to be the most robust in differentiating the 2 groups. The theoretical implications of interpersonal variables are discussed in relation to the termination and continuation of patients in psychotherapy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Premature psychotherapy termination is a frequent phenomenon in most clinical settings.
“Firstly, premature psychotherapy termination is a frequent phenomenon in most clinical settings (Hilsenroth et al., 1995; Strosahl et al., 2012).”
From A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression (2020) · cites this paper as Hilsenroth et al., 1995
Cited by
Sorted by citations
The Rorschach: Facts, fictions, and future.
Viglione, D. J., & Hilsenroth, M. J. (2001) · Psychological Assessment · doi:10.1037/1040-3590.13.4.452 · Cited by 128 · see citing works
Self-citationMeyer, G. J., & Handler, L. (1997) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6901_1 · Cited by 89 · see citing works
Self-citationAdvancing the science of psychological assessment: The Rorschach Inkblot Method as exemplar.
Weiner, I. B. (2001) · Psychological Assessment · doi:10.1037/1040-3590.13.4.423 · Cited by 68 · see citing works
What went wrong? Therapists’ reflections on their role in premature termination
Piselli, A., Halgin, R. P., & MacEwan, G. (2011) · Psychotherapy Research · doi:10.1080/10503307.2011.573819 · Cited by 57 · see citing works
“Hilsenroth, Handler, Toman, and Padawer ( 1995 ) compared treatment terminators and completers on personality measures and found that clients who ended therapy prematurely tended to be less aggressive, more cooperative, and less in need of closeness.”
BackgroundEmpirical support for interrater reliability of Rorschach Comprehensive System coding
Viglione, D. J., & Taylor, N. (2002) · Journal of Clinical Psychology · doi:10.1002/jclp.10121 · Cited by 56 · see citing works
Ruiz, F. J., Luciano, C., Flórez, C. L., Suárez-Falcón, J. C., & Cardona-Betancourt, V. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00356 · Cited by 49 · see citing works
Ruiz, F. J., Peña-Vargas, A., Ramírez, E. S., Suárez-Falcón, J. C., García-Martín, M. B., García-Beltrán, D. M., Henao, Á. M., Monroy-Cifuentes, A., & Sánchez, P. D. (2020) · Psychotherapy · doi:10.1037/pst0000273 · Cited by 48 · see citing works
Whither the Rorschach? An analysis of the evidence.
Hunsley, J. D., & Bailey, J. M. (2001) · Psychological Assessment · doi:10.1037/1040-3590.13.4.472 · Cited by 45 · see citing works
Gacono, C. B. (1998) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x98421005 · Cited by 37 · see citing works
Anestis, J. C., Finn, J. A., Gottfried, E. D., Arbisi, P. A., & Joiner, T. E. (2014) · Assessment · doi:10.1177/1073191114541672 · Cited by 32 · see citing works
“While some studies have examined mean Validity Scale levels in relation to treatment outcome (e.g., Hilsenroth et al., 1995), no study to our knowledge has examined the Validity Scales predictively and none have used the MMPI-2-RF Validity Scales.”
ResultPredicting nonmutual therapy termination with the personality assessment inventory
Hopwood, C. J., Ambwani, S., & Morey, L. C. (2007) · Psychotherapy Research · doi:10.1080/10503300701320637 · Cited by 29 · see citing works
“…(e.g., dropout, premature termination, nonmutual termination; Baity, 2003, Wierzbicki & Pekarik, 1993) and how to handle special cases that are not easily classified as mutual or nonmutual terminators (Chisholm et al., 1997; Corning & Malofeeva, 2004; Hilsenroth et al., 1995; Minnix et al., 2005).”
BackgroundResultPredictors of Early Termination in a University Counseling Training Clinic
Lampropoulos, G. K., Schneider, M. K., & Spengler, P. M. (2009) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2009.tb00547.x · Cited by 27 · see citing works
“However, as with Hilsenroth et al. (1995), Richmond’s clinic differs from the present clinic in that the therapists were predoctoral interns in clinical psychology and worked within a psychodynamic approach with well-educated clients.”
BackgroundBeginning and end of treatment of patients who dropped out of psychoanalytic psychotherapy
Jung, S., Serralta, F. B., Nunes, M. L. T., & Eizirik, C. L. (2013) · Trends in Psychiatry and Psychotherapy · doi:10.1590/s2237-60892013000300005 · Cited by 25 · see citing works
Anestis, J. C., Gottfried, E. D., & Joiner, T. E. (2014) · Assessment · doi:10.1177/1073191114536771 · Cited by 24 · see citing works
“Given the inconsistencies apparent when examining the past literature on treatment and the MMPI and MMPI-2 scales (e.g., Chisholm et al., 1997; Craig, 1984; Hilsenroth et al., 1995; Minnix et al., 2005), the consistent relationship of externalizing scales on the MMPI-2-RF and treatment outcome is notable.”
BackgroundMethodBernaud, J., & Caron, M. (2004) · L’Orientation scolaire et professionnelle · doi:10.4000/osp.2236 · Cited by 21 · see citing works
Lis, A., Parolin, L. A. L., Calvo, V., et al. (2007) · Journal of Personality Assessment · doi:10.1080/00223890701583614 · Cited by 20 · see citing works
“The Comprehensive System (CS; Exner, 1974, 1991, 1993; Exner & Weiner, 1995), since its appearance in 1974, has become the most widely researched (Shontz & Green, 1992) and most commonly taught ( Hilsenroth, Handler, Toman, & Padawer, 1995 ) system for administering, scoring, and interpreting Rorschach responses.”
BackgroundEffectiveness of child psychoanalytic psychotherapy in a clinical outpatient setting
Deakin, E. K., & Nunes, M. L. T. (2009) · Journal of Child Psychotherapy · doi:10.1080/00754170903244621 · Cited by 19 · see citing works
“Secondly, based on the literature, variables considered important to evaluate psychotherapy outcome were selected (Weiner and Exner, 1991; Blatt and Ford, 1994; Hilsenroth et al., 1995).”
BackgroundMethodContemporary Perspectives on Rorschach Assessment
Weiner, I. B. (1999) · European Journal of Psychological Assessment · doi:10.1027//1015-5759.15.1.78 · Cited by 19 · see citing works
Opaas, M., Hartmann, E., Wentzel‐Larsen, T., & Varvin, S. (2015) · Journal of Personality Assessment · doi:10.1080/00223891.2015.1089247 · Cited by 17 · see citing works
Minnix, J. A., Reitzel, L. R., Repper, K. K., Burns, A. B., Williams, F. M., Lima, E. N., Cukrowicz, K. C., Kirsch‐Darrow, L., & Joiner, T. E. (2005) · Personality and Individual Differences · doi:10.1016/j.paid.2004.11.006 · Cited by 15 · see citing works
Evaluation des psychothérapies : l'apport du Rorschach (S.I.)
Fouques, D. (2004) · Psychologie Française · doi:10.1016/j.psfr.2004.02.002 · Cited by 11 · see citing works
Predictors of outcome in a short-term psychiatric day hospital program
Kent, M., Busby, K., Johnston, M., et al. (2000) · General Hospital Psychiatry · doi:10.1016/s0163-8343(00)00061-x · Cited by 11 · see citing works
Smith, J. D., Ryzin, M. J. V., Fowler, J. C., et al. (2013) · Journal of Personality Assessment · doi:10.1080/00223891.2013.834439 · Cited by 10 · see citing works
Self-citationNygren, M. (2004) · Rorschachiana Journal of the International Society for the Rorschach · doi:10.1027/1192-5604.26.1.110 · Cited by 10 · see citing works
Strauss, J. L., Guerra, V. S., Marx, C. E., Eggleston, A. M., & Calhoun, P. S. (2010) · Improving Patient Treatment Adherence · doi:10.1007/978-1-4419-5866-2_9 · Cited by 8 · see citing works
CYRANKA, K. M., Rutkowski, K., Mielimąka, M., Sobański, J. A., Klasa, K., Müldner-Nieckowski, Ł., Dembińska, E., Smiatek-Mazgaj, B., & Rodziński, P. (2015) · Psychiatria Polska · doi:10.12740/pp/onlinefirst/40020 · Cited by 9 · see citing works
Elfhag, K., Barkeling, B., Carlsson, A. M., Lindgren, T. W., & Rössner, S. (2004) · Journal of Personality Assessment · doi:10.1207/s15327752jpa8202_4 · Cited by 8 · see citing works
“Higher levels of COP, on the other hand, have been related to premature termination of psychotherapy, indicating that more cooperative relationships imply less need for the therapist ( Hilsenroth, Handler, Toman, & Padawer, 1995 ).”
BackgroundMichael, K. D., Furr, R. M., Masters, K. S., et al. (2009) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-008-9109-x · Cited by 7 · see citing works
Object representation quality, therapeutic alliance, and psychotherapy process
Sanders, A., Hilsenroth, M. J., & Fowler, J. C. (2014) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2014.78.3.197 · Cited by 7 · see citing works
Self-citationTasca, G. A. (1999) · Psychotherapy Research · doi:10.1093/ptr/9.2.232 · Cited by 7 · see citing works
Bouvet, C., & Cleach, C. (2010) · L Encéphale · doi:10.1016/j.encep.2010.03.008 · Cited by 6 · see citing works
Use of the Rorschach in Forensic Settings for Treatment Planning and Monitoring
Jumes, M. T., Oropeza, P. P., Gray, B. T., et al. (2002) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x02463004 · Cited by 6 · see citing works
Rorschach-CS Scores of Six Groups of Patients
Berghout, C. C., Zevalkink, J., Pieters, A. N. J., et al. (2013) · Rorschachiana Journal of the International Society for the Rorschach · doi:10.1027/1192-5604/a000039 · Cited by 5 · see citing works
Symptom reduction and termination: client change and therapist identified reasons for saying goodbye
Bartholomew, T. T., Lockard, A. J., Folger, S. F., Low, B. E., Poet, A. D., Scofield, B. E., & Locke, B. D. (2017) · Counselling Psychology Quarterly · doi:10.1080/09515070.2017.1367272 · Cited by 5 · see citing works
“Common convention holds that client premature termination (Corning et al., 2007; Garfield, 1994) also referred as early termination (e.g. Hilsenroth et al., 1995), is often associated with negative therapeutic experiences and poor therapeutic outcomes.”
BackgroundMethodBernaud, J., Ardouin, T., Declercq, E., & Leroux, C. (2009) · Psychologie du Travail et des Organisations · doi:10.1016/s1420-2530(16)30172-8 · Cited by 4 · see citing works
Iwasa, K., & Ogawa, T. (2016) · Journal of Personality Assessment · doi:10.1080/00223891.2015.1099540 · Cited by 3 · see citing works
Mouret, S., & Gaudriault, P. (2011) · Psychologie Française · doi:10.1016/j.psfr.2010.11.001 · Cited by 2 · see citing works
Tryon, G. S. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809324-5.05306-2 · Cited by 1 · see citing works
Rorschach Comprehensive Variables and Assessment for Psychodynamic Psychotherapy
Nygren, M. (2005) · PsycEXTRA Dataset · doi:10.1037/e530302013-001 · Cited by 1 · see citing works
The Treatment and Management of Female Offenders
Smith, J. M., Gacono, C. B., & Cunliffe, T. B. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823372-6.00008-4
Effectiveness of Timeline Therapy under Hypnosis for the Management of Anxiety among Rescuers
Khan, J. A. (2022) · Journal of Development and Social Sciences · doi:10.47205/jdss.2022(3-iii)29 · Cited by 1 · see citing works
An Analysis of Caregiver–Child Responses on the Thematic Apperception Test (TAT)
Bloom, H., Tuber, S., & Rudenstine, S. (2026) · Journal of Infant Child and Adolescent Psychotherapy · doi:10.1080/15289168.2026.2634643
“Importantly, the TAT has been effective in differentiating patients from different diagnostic groups and in predicting their responses to treatment (Ackerman et al., 2001; Cook et al., 1995; Hilsenroth et al., 1995; Horner & Diamond, 1996).”
Dobnik, S. C., Miloševič, S. B., & Bon, J. (2026) · Psychiatry International · doi:10.3390/psychiatryint7040160
“…progress in children with diverse mental disorders [27], post-hospitalization psychosocial adjustment in adult inpatients [28], functioning in therapeutic communities [29], treatment difficulty and therapeutic alliance [30], premature termination [31], and overall psychotherapy effectiveness [32].”
- Authors
- Hilsenroth, M. J., Handler, L., Toman, K. M., & Padawer, J. R.
- Affiliations
- Cambridge Hospital (US)
- ORCID
- Hilsenroth, Mark J.
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 1995
- Volume
- 63
- Issue
- 6
- Pages
- 956-965
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2155378233
- Cited by
- 67
- References
- 0
- Citations by year
- 2026: 2 · 2024: 2 · 2022: 1 · 2021: 1 · 2020: 2 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- Rorschach test, MMPI-2, individual psychotherapy, interpersonal relatedness, psychological resources, psychopathology, personality assessment
- MeSH terms
- Adult, Mental Disorders, Female, Humans, Interpersonal Relations, Male, Middle Aged, MMPI, Patient Dropouts, Psychoanalytic Therapy, Psychometrics, Risk Factors, Rorschach Test
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
