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Letters to the Editor
May 2007

Questions Concerning the Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy

Arch Gen Psychiatry. 2007;64(5):609-610. doi:10.1001/archpsyc.64.5.609-c

I’m writing as a consultant to the study in the June 2006 issue of the ARCHIVES, “Outpatient Psychotherapy for Borderline Personality Disorder: Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy.”1 The topic is important, but I regretfully have to object to aspects of this study and question its conclusions. Besides the facts that (1) the patient group treated by psychodynamic therapists was more symptomatic and (2) a completers analysis, which I know was done, was not published, there is an issue concerning what therapy was delivered. The question of adherence is essential to any psychotherapy research and in this study, we must consider both observation of the therapists' work and the authors' “integrity check.”

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