Free-Association Session Scale: factor structure and preliminary validity test

Rachele Mariani; Cinzia Di Monte; Luca Caricati; Tiziana Bastianini; Anna Ferruta; Christian Christopher; Anna Maria Speranza; Benedetta Guerrini Degli Innocenti; Alessandro Musetti

doi:10.3389/fpsyg.2023.1169372

Free-Association Session Scale: factor structure and preliminary validity test

Front Psychol. 2023 Jun 1:14:1169372. doi: 10.3389/fpsyg.2023.1169372. eCollection 2023.

Authors

Rachele Mariani¹, Cinzia Di Monte¹, Luca Caricati², Tiziana Bastianini³, Anna Ferruta³, Christian Christopher⁴, Anna Maria Speranza¹, Benedetta Guerrini Degli Innocenti³, Alessandro Musetti²

Affiliations

¹ Department of Dynamic and Clinical Psychology and Health Studies "Sapienza", University of Rome, Rome, Italy.
² Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy.
³ Società Psicoanalitica Italiana, International Psychoanalytical Association, Rome, Italy.
⁴ Department of Psychology, City College, City University of New York, New York, NY, United States.

Abstract

One of the main concepts of the psychoanalytic method postulated by Freud in 1912 is the fundamental rule, which involves asking the patient to say whatever comes to mind as the analyst follows the patient's speech with fluctuating attention. Despite different theoretical models, this concept has remained an invariant element that characterizes the psychoanalytic method. For this reason, the purpose of the current study is to present a new instrument that measures this process based on the clinician's assessment. The Free-Association Session Scale (FASS) has been designed according to the psychoanalytic framework. Study 1 presented the preliminary validation of the FASS factor structure. Experienced Italian psychoanalysts (N = 281; 196 women) completed the FASS and sociodemographic questionnaire. The following two factors were identified using exploratory factor analysis: (1) Perturbing, and (2) Associativity. Study 2 cross-validated the two factors using an independent sample (N = 259; 187 women) of experienced psychoanalysts and confirmatory factor analysis (CFA). The FASS has been tested for concurrent validity using the Session Evaluation Questionnaire (SEQ) and Linguistic measures of the Referential process. The two-factor model achieved a close-fit test, and the FASS items were found to measure the corresponding factors with good reliability. The Perturbing factor is negatively associated with three SEQ factors (Depth, Smoothness, and Positivity) and negatively correlated with symbolization (IWRAD and IWRAD_IWRRL), confirming a more complex and unexpected session. The Associativity factor is positively associated with all four SEQ factors (Depth, Smoothness, Positivity, and Arousal). In conclusion, the FASS is a promising new questionnaire for assessing psychoanalytic session quality processes with satisfactory validity and reliability.

Keywords: clinician measure; free-association; psychoanalysis; psychotherapy process; quality session.

Grants and funding

This research was supported by a research grant from the International Psychoanalytical Association (IPA) Fund 2021 #79 The function of free association and free-floating attention in the analytic process: A new empirical tool from the analyst's perspective.