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Research in Psychotherapy: Psychopathology, Process and Outcome

Editor-in-Chief: Mariagrazia Di Giuseppe | Scientific Director: Vittorio Lingiardi | eISSN 2239-8031 - pISSN 2499-7552

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  • Psychological treatments are as effective as pharmacotherapies in the treatment of adult depression: a summary from Randomized Clinical Trials and neuroscience evidence

    Pim Cuijpers, Claudio Gentili
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.273
    3899
    PDF: 2813
    HTML: 2058
  • Psychotherapies for Anxiety and Depression: benefits and costs

    Research Group for treatment for Anxiety and Depression
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.284
    3203
    PDF: 1938
    HTML: 309
  • The transition to online psychotherapy during the pandemic: a qualitative study on patients’ perspectives

    Cecilia Giordano, Ivan Ambrosiano , Maria Teresa Graffeo, Alessandro Di Caro, Salvatore Gullo
    2022-11-04
    https://doi.org/10.4081/ripppo.2022.638
    5970
    PDF: 2008
    HTML: 58
  • More than one way home - Student raters' impressions of interventions and group processes in mentalisation based group psychotherapy and group analytic psychotherapy

    Johannes Pries, Alexander Niecke, Annekatrin Vetter, Ulrich Schultz-Venrath
    2022-12-29
    https://doi.org/10.4081/ripppo.2022.642
    5132
    PDF: 671
    HTML: 27
  • Transference interpretation and psychotherapy outcome: a systematic review of a no-consensus relationship

    Meltem Yilmaz, Kutlu Kağan Türkarslan, Ludovica Zanini, Dilara Hasdemir, Grazia Fernanda Spitoni, Vittorio Lingiardi
    2024-05-02
    https://doi.org/10.4081/ripppo.2024.744
    4985
    PDF: 1752
    SUPPLEMENTARY MATERIAL: 235
    HTML: 110
  • Some critical considerations about the document Psychotherapies for Anxiety and Depression: benefits and costs

    Nino Dazzi
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.281
    1485
    PDF: 788
    HTML: 96
  • Further reflections about the document: Psychotherapy for Anxiety and Depression: benefits and costs

    Franco Del Corno
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.283
    1771
    PDF: 849
    HTML: 203
  • An American scientist's iconoclastic response to Psychotherapies for Anxiety and Depression: benefits and costs

    Joseph A. Hirsch
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.275
    1239
    PDF: 965
    HTML: 247
  • Personal therapeutic approach in Gestalt therapists working with clients suffering from medically unexplained psychosomatic symptoms

    Jan Roubal, Roman Hytych, Michal Čevelíček, Tomáš Řiháček
    2021-12-20
    https://doi.org/10.4081/ripppo.2021.535
    9314
    PDF: 2193
    Appendix: 243
    HTML: 100
  • Psychoanalytic psychotherapy and the pregnant therapist: a literature review

    Fernanda Munhoz Driemeier Schmidt, Guilherme Pacheco Fiorini, Vera Regina Rohnelt Ramires
    2015-12-23
    https://doi.org/10.4081/ripppo.2015.185
    3405
    PDF: 4730
  • Effectiveness is the gold standard of clinical research

    Francesco Gazzillo, Adriano Schimmenti, Ivan Formica, Alessandra Simonelli, Sergio Salvatore
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.278
    2705
    PDF: 1470
    HTML: 647
  • The clinical consequence of positive mental health in psychotherapy

    Mario Fulcheri, Danilo Carrozzino
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.280
    2256
    PDF: 987
    HTML: 182
  • Patient personality and therapist responses in the psychotherapy of adolescents with depressive disorders: toward the Psychodynamic Diagnostic Manual - third edition

    Annalisa Tanzilli, Flavia Fiorentino, Marianna Liotti, Gabriele Lo Buglio, Ivan Gualco, Vittorio Lingiardi, Carla Sharp, Riccardo Williams
    2024-03-27
    https://doi.org/10.4081/ripppo.2024.752
    2383
    PDF: 1012
    HTML: 73
  • Assessing personality change with Blatt's anaclitic and introjective configurations and Shedler-Westen Assessment Procedure profiles: two case studies in psychodynamic treatment

    Osmano Oasi, Laura Buonarrivo, Alberto Codazzi, Margherita Passalacqua, Gio Matteo Risso Ricci, Francesca Straccamore, Roberto Bezzi
    2017-04-19
    https://doi.org/10.4081/ripppo.2017.231
    3026
    PDF: 1259
    HTML: 866
  • Acceptability of an adventure video game in the treatment of female adolescents with symptoms of depression

    Alvaro E. Carrasco
    2016-04-18
    https://doi.org/10.4081/ripppo.2016.182
    8416
    PDF: 2833
    HTML: 849
  • Trauma focused-cognitive behavioral therapy training effectiveness in promoting professional development of psychotherapists working with unaccompanied minors in Greece: a non-blinded randomized control trial

    Vasiliki Yotsidi, Theodora Anastasiou, Konstantinos Doulgeris, Panagiota Theodosiou, Clive Richardson
    2024-08-27
    https://doi.org/10.4081/ripppo.2024.796
    2157
    PDF: 570
    HTML: 87
  • Italian validation of the Clinical Outcomes in Routine Evaluation-10 (CORE-10): a short measure for routine outcome monitoring in clinical practice

    Antonino La Tona, Sofia Tagini, Agostino Brugnera, Barbara Poletti, Edoardo Nicolò Aiello, Gianluca Lo Coco, Lidia Del Piccolo, Angelo Compare
    2023-04-04
    https://doi.org/10.4081/ripppo.2023.671
    3109
    PDF: 1013
    Supplementary Material: 232
    HTML: 50
  • Holding the treatment frame: borderline features, personality functioning, and psychotherapy dropout in a youth mental health service

    Francesca De Salve, Chiara Rossi, Osmano Oasi, Lara Malvini, Maria Meliante, Mauro Percudani, Irene Messina
    2026-04-30
    https://doi.org/10.4081/ripppo.2026.893
    1303
    PDF: 498
    HTML: 176
  • Effectiveness of Jungian psychotherapy in supervised training settings

    Christian Roesler, Elisabeth Schörry-Volk, Anette Müller, Edem Dotse Zikpi, Wolfram Keller, Miray Kayacan
    2025-08-25
    https://doi.org/10.4081/ripppo.2025.869
    5579
    PDF: 3651
    HTML: 94
  • A theoretical and clinical perspective of an embodied view in psychotherapy of somatic symptoms disorders

    Maria Eugenia Moneta, Horst Kaechele
    2023-08-25
    https://doi.org/10.4081/ripppo.2023.605
    2730
    PDF: 1053
    HTML: 96
  • In-session emotional experiencing in brief psychotherapy conducted by trainee psychologists: process, alliance, and the role of therapist persuasiveness

    Andreia Soares, Laura Ladislau, Ana Aleixo, João M. Santos, Daniel Sousa
    2026-04-29
    https://doi.org/10.4081/ripppo.2026.891
    1161
    PDF: 481
    SUPPLEMENTARY MATERIAL: 87
    HTML: 188
  • Effectiveness of dialectical behavior therapy as a transdiagnostic treatment for improving cognitive functions: a systematic review

    CV Vijayapriya, Rameshbabu Tamarana
    2023-07-04
    https://doi.org/10.4081/ripppo.2023.662
    9687
    PDF: 3107
    HTML: 216
  • Facilitative interpersonal skills are relevant in child therapy too, so why don’t we measure them?

    Jordan Bate, Angelica Tsakas
    2022-05-09
    https://doi.org/10.4081/ripppo.2022.595
    3136
    PDF: 1437
    HTML: 62
  • The Competing Influences of Initial Depressive Symptomatology and Early Alliance on Early Outcome: A Preliminary Study

    Giorgio Gabriele Alberti, Anna Martorano, Bruno Martorano
    109-118
    2014-05-24
    https://doi.org/10.4081/ripppo.2013.33
    1707
    PDF: 898
  • Facets of the psychotherapy relationship: a metaphorical approach

    Tomáš Řiháček, Jan Roubal, Katarína Motalová
    2021-01-14
    https://doi.org/10.4081/ripppo.2020.468
    2371
    PDF: 900
    HTML: 50
  • The Evolution of Communicative Intentions During Change Episodes and Throughout the Therapeutic Process

    Paula Dagnino, Mariane Krause, Carola Pérez, Nelson Valdès, Alemka Tomicic
    75-86
    2013-02-17
    https://doi.org/10.4081/ripppo.2012.107
    1736
    PDF: 1259
  • Metacognitive interpersonal therapy-eating disorders versus cognitive behavioral therapy for eating disorders for non-underweight adults with eating disorders: study protocol for a pilot pre-registered randomized controlled trial

    Gloria Fioravanti, Martina Nicolis, Angus MacBeth, Giancarlo Dimaggio, Raffaele Popolo
    2023-08-28
    https://doi.org/10.4081/ripppo.2023.690
    4245
    PDF: 1681
    HTML: 58
  • Change and sustained recovery in defense mechanisms and depression in a pilot study of antidepressant medications plus up to 18 months of psychotherapy for recurrent major depression

    John Christopher Perry, Claire J. Starrs, Trent Semeniuk, Elisabeth Banon, Ruta Westreich
    2025-12-31
    https://doi.org/10.4081/ripppo.2025.885
    884
    PDF: 439
    HTML: 32
  • Assessing therapist and clinician competency in parent-infant psychotherapy: The REARING coding system (RCS) for the group attachment based intervention (GABI)

    Kelsey Armusewicz, Miriam Steele, Howard Steele, Anne Murphy
    2022-03-01
    https://doi.org/10.4081/ripppo.2022.562
    3680
    PDF: 1135
    HTML: 54
  • The evaluation of outcomes and process in psychotherapies offered by Mental Health Centers and an University Clinical Psychology Center

    Alessandra De Coro, Silvia Andreassi, Rachele Mariani, Elisabetta Iberni, Valeria Crisafulli, Adriana Matarrese
    125–146
    2011-02-23
    https://doi.org/10.4081/ripppo.2010.35
    2492
    PDF: 8227
  • The influence of pharmaceutical companies

    Paolo Migone
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.276
    3006
    PDF: 1461
    HTML: 1417
  • Cooperation within the therapeutic relationship improves metacognitive functioning: preliminary findings

    Benedetto Farina, Marianna Liotti, Claudio Imperatori, Lucia Tombolini, Elena Gasperini, Paola Mallozzi, Marianna Russo, Giorgia Simoncini Malucelli, Fabio Monticelli
    2023-11-08
    https://doi.org/10.4081/ripppo.2023.712
    2477
    PDF: 887
    HTML: 89
  • New horizons in group psychotherapy research and practice from third wave positive psychology: a practice-friendly review

    Cheri L. Marmarosh, Steven Sandage, Nathaniel Wade, Laura E. Captari, Sarah Crabtree
    2022-11-04
    https://doi.org/10.4081/ripppo.2022.643
    14394
    PDF: 3714
    HTML: 113
  • Effectiveness of internet-delivered dialectical behavior therapy skills training on executive functions among college students with borderline personality traits: a non-randomized controlled trial

    CV Vijayapriya, Rameshbabu Tamarana
    2023-10-30
    https://doi.org/10.4081/ripppo.2023.694
    3699
    PDF: 1602
    HTML: 132
  • A systematic review on the role of therapist characteristics in the treatment of eating disorders

    Gaia Albano, Arianna Teti, Arianna Scrò, Rubinia Celeste Bonfanti, Lucia Fortunato, Gianluca Lo Coco
    2024-07-10
    https://doi.org/10.4081/ripppo.2024.750
    4044
    PDF: 1567
    SUPPLEMENTARY MATERIAL: 337
    HTML: 263
  • Introduction

    Giovanna Esposito, Ulrich Schultz-Venrath
    2022-12-29
    https://doi.org/10.4081/ripppo.2022.683
    2018
    PDF: 501
  • The role of oxytocin as an indicator of outcome and therapeutic alliance

    Chiara Durante, Giulia Di Vincenzo, Alessandra Minutoli, Giampaolo Nicolais, Valeria Carola
    2025-06-24
    https://doi.org/10.4081/ripppo.2025.842
    1449
    PDF: 909
    HTML: 15
  • Characteristics of effective online interventions: implications for adolescents with personality disorder during a global pandemic

    Samantha Reis, Emily L. Matthews, Brin F.S. Grenyer
    2021-01-20
    https://doi.org/10.4081/ripppo.2020.488
    23927
    PDF: 1315
    HTML: 44
  • Development and preliminary validation of the Clinician Affective REsponse (CARE) scale

    Alberto Stefana, Paolo Fusar-Poli, Joshua Langfus, Eduard Vieta, Eric Youngstrom
    2024-03-21
    https://doi.org/10.4081/ripppo.2024.736
    2466
    PDF: 1186
    APPENDIX: 313
    SUPPLEMENTARY MATERIALS: 290
    HTML: 52
  • The effectiveness of short-term dynamic/interpersonal group therapy on perfectionism; assessment of anxiety, depression and interpersonal problems

    Shirzad Babaei, Mahmood Dehghani, Fahimeh Fathali Lavasani, Ahmad Ashouri, Leila Mohamadi
    2022-12-29
    https://doi.org/10.4081/ripppo.2022.656
    3375
    PDF: 1391
    HTML: 82
  • Rate of speech and emotional-cognitive regulation in the psychotherapeutic process: a pilot study

    Marco Tonti, Omar C.G. Gelo
    2016-10-19
    https://doi.org/10.4081/ripppo.2016.232
    2589
    PDF: 1166
    HTML: 901
  • Does technique matter? A multilevel meta-analysis on the association between psychotherapeutic techniques and outcome

    Christin Janine Grevenhaus, Christoph Flückiger, Lea Theimer, Cord Benecke
    2024-08-29
    https://doi.org/10.4081/ripppo.2024.803
    6417
    PDF: 2196
    HTML: 66
  • Self-assessment of patterns of subjective experience: development and psychometric study of the States of Mind Questionnaire

    Bruno Faustino, António Branco Vasco, Giancarlo Dimaggio, Ana Nunes da Silva; Sophie Seromenho
    2021-01-20
    https://doi.org/10.4081/ripppo.2020.465
    2455
    PDF: 955
    HTML: 31
  • Beyond the mask of deference: exploring the relationship between ruptures and transference in a single-case study

    Francesca Locati, Pietro De Carli, Emanuele Tarasconi, Margherita Lang, Laura Parolin
    2016-10-19
    https://doi.org/10.4081/ripppo.2016.212
    2839
    PDF: 1457
    HTML: 2127
  • Motivations to become psychotherapists: beyond the concept of the wounded healer

    Gianluca Cruciani, Marianna Liotti, Vittorio Lingiardi
    2024-08-26
    https://doi.org/10.4081/ripppo.2024.808
    9456
    PDF: 3557
    HTML: 1011
  • Reflective functioning and personal recovery process of users with borderline personality disorder on Instagram: an explorative study using computerized and thematic analysis

    Giovanna Esposito, Viviana Perla, Raffaella Passeggia, Erik Fertuck, Erhard Mergenthaler
    2021-01-18
    https://doi.org/10.4081/ripppo.2020.463
    2804
    PDF: 1013
    HTML: 59
  • Developing a prototype for relationship therapy psychoanalysis: an empirical study with the Psychotherapy Process Q-set

    Laura Bonalume, Laura Corbelli, Mattia Ferro, Anna Lisa Mazzoleni, Maria Pia Roggero
    2023-03-24
    https://doi.org/10.4081/ripppo.2023.674
    2542
    PDF: 820
    HTML: 33
  • Professional burnout in therapists working with LGBTQ+ patients: associations with defenses and reflective functioning

    Gianluca Cruciani, Jacopo Tracchegiani, Maria Quintigliano, Selene Mezzalira, Cristiano Scandurra, Nicola Carone
    2025-12-31
    https://doi.org/10.4081/ripppo.2025.880
    1325
    PDF: 718
    HTML: 99
  • Assessing children’s defense mechanisms with the Defense Mechanisms Rating Scales Q-sort for Children

    Mariagrazia Di Giuseppe, Tracy A. Prout, Lauren Ammar, Thomas Kui, Ciro Conversano
    2021-12-21
    https://doi.org/10.4081/ripppo.2021.590
    4580
    PDF: 1701
    HTML: 891
  • A pilot study of the Italian adaptation of the Session Evaluation Questionnaire fourth version

    Diego Rocco, Silvia Salcuni, Elena Antonelli
    2017-07-06
    https://doi.org/10.4081/ripppo.2017.269
    2591
    PDF: 1212
    HTML: 138
  • The association of interpersonal distress with negative mental health outcomes in people with a diagnosed anxiety disorder: a meta-analytic review

    Malenka Areas, Cristoph Flückiger, Juan Martín Gómez Penedo
    2026-07-01
    https://doi.org/10.4081/ripppo.2026.894
    331
    PDF: 243
    HTML: 22
  • Analysis of a dream series by the Dream Coding System developed by Ulrich Moser

    Gabriela Pap, Fritz Lackinger, Gerhard Kamp, Henriette Löffler-Stastka
    2021-08-24
    https://doi.org/10.4081/ripppo.2021.538
    5306
    PDF: 1096
    HTML: 112
  • Beyond self-criticism and dependency: structural functioning of depressive patients and its treatment

    Guillermo de la Parra, Paula Dagnino, Camila Valdés, Mariane Krause
    2017-04-19
    https://doi.org/10.4081/ripppo.2017.236
    2951
    PDF: 1421
    HTML: 469
  • Effect of defense mechanisms on the longitudinal development of interpersonal problems during outpatient therapy

    Jonas Schmitt, Matthias Volz, Cord Benecke
    2025-12-31
    https://doi.org/10.4081/ripppo.2025.878
    2176
    PDF: 931
    SUPPLEMENTARY MATERIAL: 235
    HTML: 88
  • When and for whom do psychodynamic therapists use guided imagery? Explicating practitioners’ tacit knowledge

    Jule Bauckhage, Christian Sell
    2021-12-20
    https://doi.org/10.4081/ripppo.2021.577
    3522
    PDF: 1331
    HTML: 67
  • Immersion and distancing across the therapeutic process: relationship to symptoms and emotional arousal

    Eunice Barbosa, Maria Amendoeira, Tiago Ferreira, Ana Sofia Teixeira, José Pinto-Gouveia, Joào Salgado
    2017-07-13
    https://doi.org/10.4081/ripppo.2017.258
    2561
    PDF: 1298
    HTML: 854
  • A psychodynamic contribution to the understanding of anger - The importance of diagnosis before treatment

    Paola Manfredi, Claudia Taglietti
    2022-06-30
    https://doi.org/10.4081/ripppo.2022.587
    6122
    PDF: 3908
    HTML: 440
  • Therapeutic alliance in the initial phase of psychotherapy with adolescents: different perspectives and their association with therapeutic outcomes

    Olga María Fernandez, Mariane Krause, Janet Carola Pérez
    2016-04-18
    https://doi.org/10.4081/ripppo.2016.180
    5103
    PDF: 4232
    HTML: 2873
  • Esoteric power, useless, useful: considerations about dreams in cognitive-behavioural therapy

    Antonino Carcione, Marta Santonastaso, Francesca Sferruzza, Ilaria Riccardi
    2021-08-30
    https://doi.org/10.4081/ripppo.2021.543
    3887
    PDF: 1321
    HTML: 138
  • Changes in the anaclitic-introjective personality configurations following psychoanalytic psychotherapy with young adults

    Andrzej Werbart, Siri Aldèn, Anders Diedrichs
    2017-04-13
    https://doi.org/10.4081/ripppo.2017.239
    2634
    PDF: 1143
    APPENDIX: 438
    HTML: 2123
  • Patient personality characteristics and therapeutic integration: treating borderline personality and emotionally dysregulated-dysphoric personality features

    Saryn R. Levy, Mark J. Hilsenroth, Francine Conway, Jesse Owen
    2022-06-30
    https://doi.org/10.4081/ripppo.2022.611
    3200
    PDF: 1546
    HTML: 173
  • Childhood emotional maltreatment and internalizing problems in a non-clinical sample of adolescents: a moderated-mediation model of insecure anxious attachment style and gender

    Giorgio Falgares, Giulia Costanzo, Giovanna Manna, Dorian A. Lamis
    2024-06-24
    https://doi.org/10.4081/ripppo.2024.745
    3668
    PDF: 1291
    HTML: 57
  • The contribution of Sidney Blatt's two-polarities model to the Psychodynamic Diagnostic Manual

    Vittorio Lingiardi, Nancy McWilliams, Laura Muzi
    2017-04-13
    https://doi.org/10.4081/ripppo.2017.242
    4676
    PDF: 1984
    HTML: 1188
  • Developing relational competence in psychotherapy training: a qualitative study of trainees’ perspectives

    Giovanna Trimoldi, Marco Sambin, Pietro Spataro, Giulia Gagliardini, Irene Messina
    2026-04-22
    https://doi.org/10.4081/ripppo.2026.890
    1584
    PDF: 566
    HTML: 181
  • ‘Isolated together’: online group treatments during the COVID-19 pandemic. A systematic review

    Giorgia Margherita, Benedetta Muzii, Alessia Caffieri, Adriana Di Francia, Brenda Somma
    2022-11-04
    https://doi.org/10.4081/ripppo.2022.639
    3886
    PDF: 1037
    HTML: 68
  • The contributions of Sidney J. Blatt: a personal and intellectual biography

    John S. Auerbach
    2017-04-13
    https://doi.org/10.4081/ripppo.2017.222
    3002
    PDF: 1114
    HTML: 2051
  • "Maybe you don’t know what answers I want": unresolved alliance ruptures preceding dropout in short-term psychoanalytic psychotherapy with depressed adolescents

    Manuela Jose Difronzo, Lisa Thackeray, Sally O'Keeffe, Ana Calderon, Nick Midgley
    2025-03-30
    https://doi.org/10.4081/ripppo.2025.841
    1390
    PDF: 793
    SUPPLEMENTARY MATERIAL: 206
    HTML: 37
  • The real relationship: the Portuguese version of the Real Relationship Inventory-Client form

    Pedro Rodrigues Ribeiro, David Dias Neto
    2023-07-05
    https://doi.org/10.4081/ripppo.2023.678
    2729
    PDF: 1182
    HTML: 121
  • The relationship between overall defensive functioning and the Personality Assessment Inventory borderline and treatment outcome scales

    Laura A. Richardson, John H. Porcerelli, Michelle Stein, Brynn DeLorenzo, Christina Massey, Emma Lindquist, Sarah McNamee, Mark Blais
    2025-12-31
    https://doi.org/10.4081/ripppo.2025.883
    1150
    PDF: 603
    HTML: 101
  • The efficacy of transdiagnostic cognitive behavioural therapy on reducing negative affect, anxiety sensitivity and improving perceived control in children with emotional disorders - a randomized controlled trial

    Elham Qanbari Alaee, Omid Saed, Sahel Khakpoor, Reza Ahmadi, Mahsa Ali Mohammadi, Majid Yoosefi Afrashteh, Zekrolah Morovati
    2022-05-09
    https://doi.org/10.4081/ripppo.2022.588
    4041
    PDF: 1447
    HTML: 124
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Keywords

  • Therapeutic interventions in intimate partner violence: an overview
    529
  • A psychodynamic contribution to the understanding of anger - The importance of diagnosis before treatment
    349
  • Effectiveness of Jungian psychotherapy in supervised training settings
    278
  • Repairing alliance ruptures in psychotherapy with adults: a scoping review
    266
  • Psychological adaptation and health-related quality of life in inflammatory bowel disease: a 5-year follow-up study
    188
Vol. 29 No. 1 (2026)
Developing relational competence in psychotherapy training: a qualitative study of trainees’ perspectives
Giovanna Trimoldi et al.
22 April 2026
Vol. 29 No. 1 (2026)
Patient experiences in receiving virtual psychotherapy: a qualitative study
Giorgio A. Tasca et al.
4 March 2026
Vol. 29 No. 1 (2026)
Examining the factor structure of the 40-item Defense Style Questionnaire among adults with depression: an individual participant data meta-analysis
Frederik J. Wienicke et al.
16 February 2026
Vol. 29 No. 1 (2026)
Eye movement desensitization and reprocessing versus cognitive behavioral therapy in the treatment of inpatients with obesity, binge eating...
Anna Guerrini Usubini et al.
16 February 2026
Research in Psychotherapy: Psychopathology, Process and Outcome

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