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Table 13 According to the Psychopathological Functioning Levels – Rating Scale (PFL-RS) raters are required to mark down the quality of patient-therapist relationship. English schedule

From: Psychopathological Functioning Levels (PFLs) and their possible relevance in psychiatric treatments: a qualitative research project

QUALITY OF THE THERAPEUTIC RELATIONSHIP

T-NO: ABSENCE OF THE THERAPEUTIC RELATIONSHIP

 No current treatments or the treatment has been discontinued.

T-OD: ALTERNATION OF DEMONSTRATION OF OPPOSITIONAL BEHAVIORS AND OPENNES TOWARDS THE THERAPIST

 The therapist is not considered as a whole but only concerning some partial functions as imagined by the patient: mirroring, accepting weaknesses or threats, being present without a relationship.

 How it can be shown: in most severe cases this consists in asking an immediate availability and then run away when the therapist can be present or as an alternation between great satisfaction when the therapist responds to the functions that the patient assigned to him/her and great oppositional behaviors when the therapist does not fulfill the patient’s expectations.

T-ID: IDEALIZED RELATIONSHIP WITH THE THERAPIST

 The most stable relationship of the patient is with his/her therapist who is imagined as always comprehensible since completely positive and not entailing any risks of abandonment.

 How it can be shown: it is recognizable because the patient seems to be unable to do without the therapist and the patient has to continuously verify the therapist’s presence and tolerates exceptions to being accepted only in favor of people who are perceived as in strict harmony with the therapist.

T-DI: DEPENDENT RELATIONSHIP WITH THE THERAPIST

 The patient lives the therapist in a realistic way but in the context of a relationship which is imagined as absolutely privileged and stable.

 How it can be shown: it is recognizable because the patient seems to be unable to do without the therapist although the therapist’s absence is tolerated, and exceptions to being accepted are tolerated only favor of people who are perceived as not in contrast with the therapist.

T-SU: THERAPEUTIC RELATIONSHIP WITH EXCESSIVE NEED OF SUPPORT

 It is a relationship between two distinct persons but the individual is afraid that the relationship with the therapist is weak and fragile.

 How it can be shown: the supportive relationship is recognizable because the patient is mainly characterized by an attitude of need (e.g., child, schoolchildren, sufferer).

T-AL: DIALOGIC THERAPEUTIC RELATIONSHIP, WITH EXCESSIVE APPREHENSION

 It is a relationship between two different persons but the individual is afraid of the relationship with a poorly reliable therapist.

 How it can be shown: the dialogic relationship is sufficiently dialogic but, in order to be accepted, the patient avoids to value the therapist’s positions.

T-RC: DIALOGIC THERAPEUTIC RELATIONSHIP, WITH EXCESSIVE NEED FOR REWARD

 It is a relationship between two different persons but the individual is afraid of the relationship with a therapist who is too far.

 How it can be shown: the relationship is sufficiently dialogic but, in order to be accepted, the patient extremely values the therapist’s positions.

T-AS: DIALOGIC THERAPEUTIC RELATIONSHIP, WITH EXCESSIVE NEED FOR ASSERTIVENESS

 It is a relationship between two different persons but the individual is afraid that the relationship with the therapist is very competitive and demanding.

 How it can be shown: the relationship is sufficiently dialogic but, in order to affirm himself/herself, the patient reduces the importance of the therapists’ positions.

T-CO: COOPERATIVE DIALOGIC THERAPEUTIC RELATIONSHIP

 It is a relationship between two different persons who cooperate with understanding and confrontation.

 How this can be shown: the relationship is sufficiently dialogic and the patient is open to consider the therapist’s positions.