A Systematic Review of the Association Between Interpretations and Immediate, Intermediate, and Distal Outcomes

Sigal Zilcha-Mano, Hadar Fisher, Tohar Dolev-Amit, John R. Keefe, Jacques P. Barber

Research output: Contribution to journalReview articlepeer-review


Interpretations are a hallmark of psychodynamic treatment and a method used in other theoretical orientations as well. Therapists use interpretations to increase patients' insight concerning unconscious and preconscious elements in their lives, with the ultimate aim to reduce mental pain and suffering and improve mental health. This systematic review focuses on the association between the therapists' use and accuracy of interpretation and immediate (within-session), intermediate (between-session), and distal (end-of-treatment) outcomes. This synthesis of the research literature is based on 18 independent samples of 1,011 total patients in individual psychotherapy. The results suggest that the use and accuracy of interpretations were associated, in half the studies, with patient disclosure of emotions and increased insight at the immediate, moment-to-moment enfolding of the session. At the intermediate postsession outcome, the use of interpretations was associated with a stronger alliance and greater depth, in half the studies. At the end of treatment, however, while there is some evidence for a positive effect of the use of interpretations on treatment success, there are also neutral effects and even evidence that interpretations have the potential to be harmful in some particular situations. The article concludes with training implications and therapeutic practices based on the integration of clinical experience and research evidence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Original languageEnglish
Pages (from-to)266-282
Number of pages17
Issue number3
Early online date6 Apr 2023
StatePublished - 6 Apr 2023

Bibliographical note

Publisher Copyright:
© 2023 American Psychological Association


  • Emotions
  • Humans
  • Mental Health
  • Professional-Patient Relations
  • Psychotherapy/methods
  • Treatment Outcome


Dive into the research topics of 'A Systematic Review of the Association Between Interpretations and Immediate, Intermediate, and Distal Outcomes'. Together they form a unique fingerprint.

Cite this