Success and failure in time-limited psychotherapy. With special reference to the performance of a lay counselor.

This article, based on data from the Vanderbilt Psychotherapy Research Project, is a detailed comparison of two patients (male college students with anxiety, depression, and social withdrawal) treated by a lay counselor in time-limited psychotherapy. One of the patients experienced noticeable therapeutic gains; the second was a therapeutic failure. Differences in process and outcome are shown to be due to the quality of the therapeutic interaction. The latter in turn, was importantly determined by the patient's character structure and the manner in which it enabled the patient to relate to the therapist. Fundamental differences exist between a trained and an untrained therapist's approach to psychotherapy. In these case histories, the lay counselor experienced difficulties with both patients in effectively confronting transference issues.