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CCRT Concept — MRCPsych Paper B MCQ

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HardPsychotherapyCCRT ConceptMRCPsych Paper B

During a brief psychodynamic assessment, a patient repeatedly describes wanting reassurance and emotional closeness, experiencing other people as critical or rejecting, and then withdrawing while feeling ashamed. The therapist analyses these relationship episodes using Luborsky's Core Conflictual Relationship Theme method. Which formulation most accurately represents the method's coding of this material?

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Correct answer: D — A wish for closeness; others experienced as rejecting; the self responding with withdrawal and shame

CCRT derives a recurring interpersonal pattern from narratives of relationship episodes. Its three components are the person's wish or need, the experienced or anticipated response from others, and the resulting response of the self. Here these are, respectively, a wish for closeness, others perceived as rejecting, and withdrawal with shame, making B correct. Option E resembles a cognitive formulation, particularly the negative cognitive triad, rather than CCRT coding. Option B is an antecedent–behaviour–consequence functional analysis and may describe the same episode behaviourally, but it does not distinguish wish, response from others and response from self. Option C describes behavioural activation, while D describes information commonly recorded on a DBT diary card.

Reference: Tallberg P, Ulberg R, Dahl HSJ, Høglend PA. Core conflictual relationship theme: the reliability of a simplified scoring procedure. BMC Psychiatry. 2020;20:150. https://pubmed.ncbi.nlm.nih.gov/32252696/