Moving Targets. Patients' Changing Complaints During Psychotherapy

Previous psychotherapy research typically assessed patients' target complaints before or shortly after the first therapy hour and then reassessed for change and improvement at termination on the same original problems. Authors of even the earliest articles, however, conceptualized target complaints as presenting problems that undergo a process of constant redefinition throughout the course of psychotherapy. Using a standardized assessment procedure recommended by Mintz (1977), the present study therefore followed 44 patients in time-limited marital or family therapy at a university outpatient clinic and offered them the opportunity to list new target complaints at subsequent assessment points in addition to the initial session. More than half of the patients (56%) reported new problems, and when these arose, they were significantly correlated with outcomes. Implications for comparative-competitive psychotherapy studies, as well as process and outcome research are offered in conclusion.