Three mechanisms of change in psychodynamic therapy: insight, affect, and alliance.

Excerpts of therapist-patient dialogue are presented to demonstrate three important elements of a successful session of psychodynamic therapy. These are the provision of insight through the use of transference, a focus on patient affect, and the therapist's attention to aspects of the therapeutic alliance. The article, in addition to explicating the clinical process in psychodynamic therapy, gives a theoretical explanation for the emphasis on each of these three elements and provides research support for their application.