Kenneth L. Critchfield

A key mechanism of psychopathology and change proposed by the theory of interpersonal reconstructive therapy (IRT; Benjamin, 2003, 2018) is termed the "gift of love" (GOL). The GOL hypothesis is that wishes to receive love and acceptance from specific internalized attachment figures shape and maintain problem patterns and their associated symptoms for many patients across a wide range of psychopathology. According to IRT theory, optimal intervention is defined by therapist alignment, or "adherence," to a core algorithm of principles that are tailored individually and bring awareness to (a) attachment-based yearnings for love and acceptance from internalized figures and (b) how those yearnings shape and motivate current problems and symptoms. The method then seeks to enhance choice about those relationships and their attendant feelings, hopes, and fears. The study sample includes 30 patients, referred while receiving inpatient treatment and followed on an outpatient basis, with complex, high-acuity clinical needs (i.e., histories of multiple psychiatric hospitalizations, recurrent suicidality, ineffectiveness of prior treatment, and significant personality pathology). Reliable measures were developed to track therapist adherence to IRT principles, as well as patient stages of change coming to terms with the GOL. IRT adherence was associated with retention, reduced depression and anxiety, and improved self-treatment. Mediation analyses support the proposition that change in IRT is contingent upon patient progress at grieving the losses and associated wishes linked to attachment figures. Implications for theory-guided research and practice at the level of underlying principles are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Two dimensions of parenting behaviors—affiliative/non-affiliative and autonomy/control— are each consistently linked to adolescent sleep health. Parenting behaviors that facilitate good sleep likely involve affiliation (i.e., warmth) and some degree of parental guidance and appropriate autonomy-granting to the adolescent; however, these domains are often confounded in parenting assessments, which limits understanding and specificity of recommendations for providers and families on how to optimize adolescents’ sleep. Thus, we categorized existing literature according to an interpersonal developmental framework to identify parenting behaviors most strongly linked to adolescent sleep health. Studies (k = 42) included 43,293 participants (M age = 14.84, SD age = 2.04). Structural analysis of social behavior (SASB) interpersonal coding was applied to define and operationalize parenting behaviors (independent variables). Dependent variables included measures of sleep health (i.e., sleep regularity, duration, efficiency, latency, timing, quality, alertness/sleepiness) and sleep disturbance. The final effect size of interest for analysis was a correlation coefficient r. Optimal parenting behaviors (e.g., warm, autonomy-granting, moderately controlling) were associated with longer sleep duration, earlier bedtime, less daytime sleepiness, shorter sleep latency, and fewer sleep disturbances. Suboptimal parenting behaviors (e.g., hostile, controlling) were associated with more daytime sleepiness and more sleep disturbances. This is one of the first studies to specify that, when paired with affiliation, both moderate control and moderate autonomy-granting were associated with better adolescent sleep health. Findings indicate that the importance of parental interpersonal warmth extends into adolescence and further suggest that the interpersonal security necessary for good sleep includes appropriate use of control and autonomy-granting behaviors.

Through detailed analysis of case examples, this work seeks to provide valuable insights for clinicians wishing to explore suicidality with their patients in ways that are informed both by existent... What is already known about this topic: In Interpersonal Reconstructive Therapy (IRT), patterns linked to suicidality can often be seen as reflecting lessons learned about self and others in the co...

Objectives: This study tests ways in which the perception of intergenerational continuity in parenting behaviors among child‐maltreatment (CM) and non‐CM families conform to Benjamin's (2006) Copy Process Theory, which considers three copy processes: Identification (be like him/her), Recapitulation (behave as if he/she is still present and in charge), and Introjection (treat myself as he/she treated me).Method: Across two home visits and a laboratory session, 171 mothers of preschoolers (M = 3.7 years) completed the SASB Intrex Questionnaire relative to herself, her history with her parents, and her present relationship with her child.Results: Mothers' retrospective reports of her interactions with caregivers were correlated with the quality of self‐reported parenting processes in interactions with her preschooler. Analyses indicated high rates of intergenerational copying in both samples for each copy process. While copying in general was observed in nearly all mothers (roughly 80%−90%) and emphasized warm, securely attached patterns, the copying of hostility and/or lack of affiliation occurred in copied profiles for about one‐third of mothers. About the more problematic profiles, CM mothers tended to rate themselves as being in the child‐like position they experienced in their own childhood, with themes involving hostile control perceived from their child. By contrast, non‐CM mothers copied disaffiliative themes primarily in relation to themselves.Conclusion: Findings verify that interpersonal patterns and internalized relational histories are important keys for understanding CM risk. The use of a method that offers interpersonal specificity at the level of individual profiles has application to clinical practice with at‐risk parents.

Most research to date with Interpersonal Reconstructive Therapy (IRT: Benjamin, 2006) involves application with patients who qualify for the acronym "CORDS": Comorbid, Often Rehospitalized, Dysfunctional, and Suicidal. A case formulation (CF) based on interpersonal copy process theory defines links between presenting symptoms and patterns of affect, cognition, and behavior that invoke safety or threat and were learned and internalized in close relationships. The "gift of love" (GOL) hypothesis is that the wish to receive love and acceptance from specific internalized attachment figures organizes and propels problem patterns and their associated symptoms. Through a series of steps, IRT seeks to help patients become aware of and learn about their copied patterns, including where they were learned, the role they play in maintaining connection with internalized attachment figures, and their functions in the present. The goal is to help a patient differentiate from their "family in the head" and pursue healthy behaviors and self-concepts. With awareness and differentiation comes the possibility of letting go of problematic quests for love and acceptance from the internalized attachments and to choose healthy alternatives instead. As an integrative method, safety planning in IRT shares much with other approaches. What is unique is how therapists utilize the CF to guard against unsafe behavior as an ongoing part of the treatment process with patients with suicidality. This article provides an overview and illustration emphasizing these unique aspects of the IRT approach to safety planning in the context of individual psychotherapy with adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Authors included in this issue of the Journal of Clinical Psychology: In-Session come from diverse theoretical orientations but discuss methods of case conceptualization that share these assumptions: (1) that interpersonal patterns are salient to a good understanding of patient personality and problems and (2) that an individual formulation is helpful in responsively tailoring in-session processes to meet therapeutic goals. We believe these assumptions resonate with many practitioners working across settings, levels of severity, and theoretical orientations. Each author offers an overview of theory as well as a detailed case description that emphasizes the implications of each formulation for the subsequent process of therapy. A final paper provides commentary across the source papers. The issue is thus evocative not only about clinical practice issues but also of underlying theory. It speaks to the challenges and possibilities of transtheoretical integrated practice and research within our focal domain of common interest, interpersonal relationships.

Feature heterogeneity and diagnostic overlap occur regularly among patients in clinical settings. In interpersonal reconstructive therapy (IRT), a case formulation focused on patterns learned in close attachment relationships guides intervention choices. This study illustrates how IRT formulation and treatment proceed, and how it may also fail when there is not close adherence to underlying principles. Don is a music professor in his 40's with a significant trauma history and complex diagnostic profile that includes many hospitalizations and suicide attempts. He qualified for several diagnostic and statistical manual of mental disorders personality disorders via formal diagnostic interviews (obsessive‐compulsive, avoidant, passive‐aggressive, narcissistic), as well as major depression, generalized anxiety, and substance abuse. Don's formulation demonstrates how self‐destruction can function as a “gift of love” to internalized representations of important caregivers. Data from work with patients like Don confirm the usefulness of Benjamin's IRT lens for navigating comorbidity, as well as the importance of underlying principles of change.

The authors wish to make the following correction to their paper