Research: Core Conflictual Relationship Theme Method (CCRT)

The Core Conflictual Relationship Theme Method (CCRT) is an instrument used in researching process of psychotherapy.  In this article, a research work is cited in which this instrument is used in psychotherapy research.

The CCRT method is a measure of central relationship schemas of a person that are revealed through his/her narratives.

The CCRT (Luborsky, 1998) is one of the most employed methods of assessing relationship patterns. Over the last decade, it has been used to study numerous forms of psychopathology and symptom impairment, as well as the process of psychotherapy.

There is also evidence that the CCRT shares many characteristics with Freud’s transference theory. The CCRT assesses interpersonal narratives in three components:

  • (1) the wishes, needs, motivations or intentions of a subject (W);
  • (2) the response of others to the subject’s wishes (RO); and
  • (3) the response of the subject to others’ response (RS).

These three components are rated using the standard categories provided by the method, which includes 35 Wishes, 30 ROs, and 31 RSs. The manual gives detailed descriptions for each Wish, RO, and RS.

The CCRT components are identified in a series of Relationship Episodes (RE) told by the subject during an interview designed to collect such narratives (Relationship Anecdotes Paradigm [RAP]). An RE is a brief story or vignette of an interaction the subject had with another person.

Table is excerpt from Bond et.al 1987

 

Table is excerpt from Bond et.al 1987

The client’s relationship pattern is studied by analyzing the recorded transcripts of the therapeutic session.

Example from Drapeau & Perry (2004) research:

Title of this research paper is: Childhood trauma and adult interpersonal functioning: A study using the Core Conflictual Relationship Theme Method (CCRT).

The interview starts with the interviewer saying: “I am going to ask you to tell me stories of interactions you have had with others that struck you as particularly important, interesting or troublesome or a combination of those. These interactions must have happened within these last 6 months.” During the interview, the interviewer inquires about the wishes or desires the subject had during the interaction, how the other person involved in the interaction felt or reacted, and how the subject felt or reacted as a result of the other person’s response. The subjects in this study freely chose which stories to report, although the direction specified three general types, specifically occupation, close relationships and any therapy or professional relationship, all within a time-frame of the past 6 months.

The narratives or relationship episodes from 119 subjects were recorded, transcribed then scored using the CCRT method, with each subject giving approximately 10 or 11 recent relationship episodes. The interviews were scored using CCRT coding procedures and the data considered quantitatively.

For any given relationship episode, the rater is required to identify :

  1. which segments represent a W, a RO, and a RS and
  2. use the definitions provided in the manual to attribute a standard category to this specific segment.

This standard category, or score, is descriptive and reflects a specific type of motive or behavior.

Considering the data quantitatively allows us to examine the proportion of each CCRT category across the entire interview in comparison with the proportions in the other categories.

Two experienced raters were used. They rated a total of 8000 relationship episodes. Consensus rating and reliability assessment were don on randomly selected cases (20% of total).

Defining Trauma: Traumatic Antecedents Interview (TAI) Scale is used to determine which of the subject have what kind of traumatic experience. These factors, together with the results of the CCRT scores were tabulated as such.



Here is an example of how the results were interpreted

Example: “Verbal abuse (see table 1). The verbally abused group reported more of the wish to be distant from others (W10; trend only). The verbally abused group experienced others as less strong (RO24) and in interpersonal interactions, they themselves more often reacted by being not open (RS8). However, none of these differences remained significant following the Bonferroni corrections.”

 

Comments

The CCRT instrument seems to give a clear quantified overview of and individual’s relationship patterns. The purpose of reading this research article was to learn about how the CCRT is applied. In addition we are also offered an insight into childhood trauma.

 

Bibliography

Bond, J. A., Hansell, J., & Shevrin, H. (1987). Locating transference paradigms in psychotherapy transcripts: Reliability of relationship episode location in the core conflictual relationship theme (CCRT) method. Psychotherapy: Theory, Research, Practice, Training24(4), 736.

Luborsky, L. (1998). The Core Conflictual Relationship Theme: A basic case formulation method. In T. D. Eells (Ed.), Handbook of psychotherapy case formulation (pp. 53–83). New York: The Guilford Press.

Luborsky, L., & Crits-Christoph, P. (1998). Understanding transference: The Core Conflictual Relationship Theme method (2nd ed.). Washington, DC: American Psychological Association.

Drapeau, M., & Perry, J. C. (2004). Childhood trauma and adult interpersonal functioning: A study using the Core Conflictual Relationship Theme Method (CCRT). Child abuse & neglect28(10), 1049-1066.