The Clinical Method of Taeyul's Sasang Simhak Reconstructed from the Surviving Record

Method — A literature-based reconstruction of clinical method (narrative review). This is not a study that evaluates effectiveness, and no formal quality appraisal was performed.

• Primary sources and citation conventions
  • 『四象心學』 Sasang Simhak: Kang Yong-hyuk, Daesung Medical Publishing, 2010. Page numbers are given in the text (e.g., Sasang Simhak p.424).
  • The Taeyul lecture collection: a scanned and edited compilation titled "Taeyul (Kim Do-sun) Lectures on Sasang Simhak" (held in the author's library, OCR-processed). It gathers posts from an online study circle together with lecture transcripts; citations give the page number of the edited compilation and the post number (e.g., Lecture Collection p.416, post #1272).
  • Classical text: the 1901 Sinchuk edition of 東醫壽世保元 Dongui Suse Bowon in the Korean Medicine Classics Database (mediclassics.kr).
  • Comparative literature: PubMed meta-analyses (searched 2026-09-27).
• Distinguishing layers of source material: every statement in this paper identifies the layer of its source. [Taeyul's record] denotes posts and case records written by Taeyul himself; [transcriber's summary] denotes passages in which a transcriber condensed a lecture; [Kang's commentary] denotes exposition in Sasang Simhak; and [this paper's reconstruction] denotes places where the author has combined or generalized the above material.
• Scope: Taeyul's method was transmitted through apprenticeship, and the author of Sasang Simhak states that "in trying to keep the principle of 비인부전 (非人不傳, biin bujeon—'not to be transmitted to one who is not the right person'), I could not openly disclose material related to clinical practice" (p.3). This paper therefore covers only what can be reconstructed from the published record. Of the 607 pages in the scanned compilation of the lecture collection, 36 pages could not be read by OCR. Twenty-five of these were restored by collation with a digital manuscript (docx) of the same lectures held in the author's library; the remaining 11 pages (a chronology, a classification table of disease patterns and prescriptions, diagrams, and similar material) were transcribed from the scanned images and then collated character by character with other digital manuscripts of the same lectures (Dongui Simhak 1, 3 and 4, the Dohae Simsin diagrams and Taeyul Suse Bowon), and corrected to the manuscripts' readings.

1. Summary

In Part 1, this series took the literature of 四象心學 Sasang Simhak—literally "the mind-study of the four constitutions," a school that reads Yi Je-ma's (李濟馬) Sasang constitutional medicine primarily through the patient's temperament and emotional disposition—as the representative of the approach centred on the analysis of temperament and emotion (性情, seongjeong). Part 2 reconstructs, from the records that survive, the procedures by which that approach was actually operated in the consulting room. The results of this reconstruction fall into four layers. First, in assessment, Taeyul (太栗, Kim Do-sun) regarded the determination of constitution as "a probabilistic inference," and the commentary of his student Kang Yong-hyuk explains a method of recording a person with a four-position code for original nature, mind type, body type, and disease-pattern type. Second, the interview survives in the transcriber's summary as three principles (patient, environment, and adaptation) and four stages running from insight into illness to individuation. Third, diary analysis appears in a single case record from 1996 as a sequence of headed items: "diary analysis: problems → problem analysis → ego-strengthening points." Fourth, therapist training is described as five to ten years of self-analysis under dual supervision. Because diary analysis and the format of the first interview rest on a single case, this paper does not establish them as a general procedure; it holds them instead as candidate procedures to be tested in Part 4. The contribution of this paper lies not in demonstrating efficacy but in drawing a line between the procedures that actually exist in the source material and the procedures that the author has constructed from that material.

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2. Context of the Question

As shown in Part 1, Sasang Simhak distinguishes itself from "the existing Sasang medical community, whose principal concerns are constitutional classification and the administration of medicine" (Sasang Simhak p.319). What it actually does, and how, is nevertheless not set out in any one place. Taeyul's lectures were posted to an online study circle and survive only as a scanned compilation, and Sasang Simhak is a book in which his student Kang Yong-hyuk comments on those lectures. Taeyul himself wrote that he planned to present clinical cases, but deferred the plan, remarking that "my heart is not yet in it, so it must wait for another day" (Lecture Collection p.71) [Taeyul's record].

If the procedures are not reconstructed, the approach remains purely a matter of individual skill: it cannot be measured, nor can it be combined with other treatments. The work of reconstruction, however, carries a risk of its own. If Taeyul's records, the transcriber's summaries, the student's commentary, and the reconstructor's synthesis are read as though they formed one continuous procedure, the result is a manual that no one ever actually used. This is why the present paper marks the source layer of every statement.

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3. What the Literature Says

1. The classical basis: holding the mind to account (責) is the direction of treatment

The chapter "On Nature and Destiny" (性命論) of Dongui Suse Bowon states that the clarity or turbidity of the mind depends not only on what one is born with but also on one's own self-examination.

存其心者, 責其心也, 心體之明暗, 雖若自然, 而責之者淸, 不責者濁.

To preserve one's mind is to hold one's mind to account. Although the brightness or darkness of the mind's substance may seem to be a matter of nature, those who hold it to account become clear, and those who do not become turbid.

— 『동의수세보원(東醫壽世保元)』 성명론 [1-37] (mediclassics.kr/books/182/volume/1#content_39)

Kang's commentary maps the "brightness and darkness" (明暗) of this article onto the conscious and the unconscious, and likens 責其心, chaek gi sim—"holding one's own mind to account," that is, deliberate self-examination—to Jungian self-analysis [Kang's commentary]. This is a correspondence drawn between two systems whose objects of observation differ, and it is the interpretation that Sasang Simhak has adopted. The chapter "Discriminating the Four Constitutional Types" (四象人辨證論) sets out the same direction as a task specific to each constitution.

余足之曰, 太陰人, 察於外, 而恒寧靜怯心, 少陽人, 察於內, 而恒寧靜懼心, 太陽人, 退一步, 而恒寧靜急迫之心, 少陰人, 進一步, 而恒寧靜不安定之心, 如此, 則必無不壽.

I add to this: the Taeeum person should look outward and constantly calm and quiet the timid mind; the Soyang person should look inward and constantly calm and quiet the fearful mind; the Taeyang person should step back and constantly calm and quiet the hurried, pressing mind; and the Soeum person should step forward and constantly calm and quiet the unsettled mind. If one does so, one cannot fail to live long.

— 『동의수세보원』 사상인변증론 [17-21] (mediclassics.kr/books/182/volume/4#content_246)

Kang writes that only when the anima has been differentiated through Sasang Simhak training can these four 恒心, hangsim—"constant minds," the habitual emotional tendency each constitution is charged with calming—finally be stabilized (p.429) [Kang's commentary].

2. Assessment: the principles of constitutional determination and the four-position code

Principles of determination. According to Taeyul's words as reported by Kang, "the classification of the Sasang types is not an objective criterion but a probabilistic inference" (Sasang Simhak p.354) [Taeyul quoted in Kang's commentary]. Of the practice of confirming a constitution by administering medicine and observing the reaction, Taeyul asked in return, "May a physician give an uncertain drug, for the sake of diagnosis, until side effects appear?" (Lecture Collection p.55) [Taeyul's record]. Determination is made through the interview. Taeyul wrote that when a judgement can be made within the range of one's experience, one should "confirm it in reverse," and that when one is not certain, one should begin with the attitude of someone learning afresh. He warned that constitutional analysis is difficult without understanding "how far a patient's answers vary according to the way the physician asks the question, and how very different the patient's actual life is from the life the patient describes" (Lecture Collection p.504) [Taeyul's record]. There is also a principle that a determination must be accompanied by a statement of its grounds. In his words, "'I regard this person as Soyang because of such-and-such': that is the attitude of doing Sasang" (Lecture Collection p.213) [lecture transcript].

The four-position code. Sasang Simhak explains a method of recording each patient with a four-character code (pp.424–425) [Kang's commentary]. The four positions correspond to the classical quartet 事·心·身·物 (sa, sim, sin, mul—affairs, mind, body, and things), which the school reinterprets as original nature, mind type, body type, and disease-pattern type. The first position records original nature (本性, bonseong; also written 性), which does not change over a lifetime, and is written as a capital letter (H, F, E, W). The remaining three positions are mind type (心), body type (身), and disease-pattern type (物). Because these can change over the course of a life, they are called 表氣, pyogi—"surface qi," the acquired, changeable layer as distinct from the fixed original nature—and are written in lower case. The example "Ehwf" is glossed as follows: the original nature is Taeeum (E); at the level of the mind the person mainly uses Taeyang qi (h); the body type is one with a well-developed lumbar and gluteal region (w); and the disease pattern belongs to the fire-heat and hyperfunction group (f). The letter in the disease-pattern position designates a group of disease patterns rather than a constitution name (h: water-retention patterns, gastric patterns, neurasthenia, insomnia, and similar; f: fire and heat patterns; e: binge eating and dampness patterns; w: cold patterns and hypofunction). For convenience the code is sometimes shortened to three positions (Ehw) or two (Eh). The same commentary also gives the time required for change in each position.

These time spans are descriptions in the commentary, not measured values.

In the 1996 case, the family's constitutions are recorded as "patient W/fe, father W/f, mother E/h" (Lecture Collection p.414) [Taeyul's record]. These notations appear to use the same letter system, but the commentary does not explain what the slash separates, how omitted positions are to be read, or whether the 1996 notation follows the same rules as that of the 2010 commentary. This paper therefore does not decode the family record into four-position codes and suspends judgement on it. Unless the rules of the code are settled, inter-rater agreement cannot be measured in Part 4, so this gap becomes the first task of Part 4.

3. The interview: three principles, four stages, and technique

The principles of interview-based treatment survive at the end of a lecture transcript. The transcriber notes, "He gave one more lecture after this, but because of problems with the recorder I will post only the main points briefly," and then records the following (Lecture Collection p.239) [transcriber's summary]. First, change the patient: help the patients themselves recognize that they are ill and need to be treated, and that "I have been tormenting my own mind"; this includes treating the illness with medicine. Second, change the patient's environment: merely leading guardians such as a spouse, parents, or children to recognize that the patient has an illness that must be treated changes the surrounding environment considerably. Third, help the patient find a way to adapt well to the environment as given. The same summary records the course of treatment as four stages: insight into illness → corrective emotional experience → re-education → individuation. The English gloss in the original is "self-actualization individualization," whereas Jung's concept of individuation (개성화 in Korean) is conventionally rendered as individuation. This paper leaves the original notation as it stands and renders the concept as individuation.

The conclusion of the 1996 case record states the same three principles in Taeyul's own words (Lecture Collection p.418) [Taeyul's record]. Here, however, the second principle has become "heal the patient's body," with the proviso that "where the illness has not become fixed in the body type, excessive administration [of medicine] is … an undesirable method of treatment." That the transcriber's summary and Taeyul's record share one framework while differing in detail indicates that these principles were not a fixed manual.

The classical chapter "On Broad Relief" (廣濟說) likewise specifies intervention in the environment by assigning helpers to each stage of life: the mother in infancy, the father and elder brothers in boyhood, younger brothers and friends in the prime of life, and children and grandchildren in old age (Dongui Suse Bowon [16-4], mediclassics.kr/books/182/volume/4#content_205).

Records of intervention technique are scattered, but their direction is consistent. Kang writes that in the interview one "first points out only the single greatest fault to be corrected" and "tells the patient a way of putting it into practice with the body" (Sasang Simhak p.399) [Kang's commentary]. Taeyul held that if one touches a patient's sore point directly, the patient runs away, and that in such cases one should explain "as allegorically and figuratively as possible" (Lecture Collection p.238) [lecture transcript]; he also said that to treat another person with respect, one must "pretend not to know" what that person will not acknowledge (same page) [lecture transcript]. He further wrote that "what matters is more often not why, but what is to be done" (Lecture Collection p.430) [Taeyul's record].

The principle of initiating intervention and consent. Taeyul wrote that "it is medical ethics that one cannot intervene unless a person seeks help, until it has become an illness" (Lecture Collection p.424) [Taeyul's record]. This is a principle concerning the conditions for beginning treatment and obtaining consent, and it differs from a discontinuation criterion that would specify when an ongoing treatment should be stopped. No explicitly stated discontinuation criterion was found in the source material.

4. Diary analysis: the record structure of a single case

The only record in which the procedure of diary analysis survives is a 1996 case (post #1272, Lecture Collection pp.413–418) [Taeyul's record]. This case is not a report published in a journal but a structured case record that Taeyul posted to the online study circle as dated entries. At the first interview, Taeyul asked for three things. The patient was to write a brief diary of each day's feelings and bring it; to think about the work and occupation she would like to pursue in future and bring those thoughts; and, regarding the auditory hallucinations, neither to strive not to hear them nor to respond to them, but to reduce the attention paid to them (p.416). The record of the second interview is set out in the original under three headings: "diary analysis: problems," "problem analysis," and "ego-strengthening points" (p.416). The table below reproduces these original headings.

The three items in the "problem analysis" column are not confirmed facts about the patient but interpretations that Taeyul recorded within a psychodynamic framework. The record does not show whether alternative interpretations were considered or whether the patient agreed with these interpretations. As section 5 of this paper shows, the Sasang Simhak literature warns that bias in the observer produces misdiagnosis, and that warning must apply equally to the therapist's interpretations.

The record gives the reason for the decision not to address the third problem directly. Taeyul judged that analysis aimed at confirming causes was dangerous while the ego was still immature, and so set ego strengthening (자아 보강, jaa bogang—building up the patient's capacity to cope before any uncovering of causes is attempted) as the goal of treatment (p.415); because the relationship with the father involved "many difficulties in terms of timing," he approached it indirectly through work (p.417).

This paper's reconstruction. This paper reconstructs the record of this case as a three-step sequence: "diary → therapist's interpretation → task returned to the patient" [this paper's reconstruction]. This sequence can be confirmed in the source material only for this one case, and there is no evidence that Taeyul used the same sequence with every patient. In Sasang Simhak training, a supervisor reads the learner's writing and poses further questions (Sasang Simhak p.385), which shows a similar flow; this, however, is a record of therapist education, not of patient treatment.

A comparison with contemporary research on expressive writing makes the difference clear. In a meta-analysis of 31 randomized controlled trials (4,012 participants), the effect of expressive writing in reducing depression, anxiety, and stress was small (Hedges' g −0.12, 95% CI −0.21–−0.04) and appeared later, at follow-up, rather than immediately after the intervention. Expressive writing treats the act of writing itself as the intervention, whereas the diary in this case was material for the interview, read and interpreted by the therapist and returned to the patient as tasks. The two are not the same intervention. Within the material reviewed for this paper, no study was found that evaluated the effect of the method used in this case.

5. Therapist training: the analyst becomes the instrument

Sasang Simhak gives three reasons why Sasang Simhak training concentrates on self-analysis rather than on clinical study. They are to correct the practitioner's centre of observation so that constitutional diagnosis is made correctly; to develop the capacity for communication with the patient in the interview after diagnosis; and to find one's true self through cultivating oneself and ordering one's household (修身齊家, susin jega) (p.351) [Kang's commentary]. The commentary explains that the observer's bias leads directly to misdiagnosis, and, using the analogy of coordinates, writes that to a practitioner with a bias of (5.5), a patient located at (3.3) appears to be at (−2.−2) (p.353). Taeyul likewise wrote that "depending on differences in the breadth of each physician's experience, or on individual psychological biases, … opinions about the same patient may differ" (Lecture Collection p.55) [Taeyul's record]. In a lecture he described Sasang as "inserting a filter between my five sensory nerves and the cerebrum," that is, "a filter with which one can check one's own deviation" (「심학공부 (녹취)」 "Study of Simhak (transcript)," corresponding to Lecture Collection pp.206–207 — Source 4-1) [lecture transcript].

The structure of training is described in the commentary [Kang's commentary]. "Graduation" takes at least five years and in some cases more than ten (p.351); in addition to the teacher who supervises the learner, another teacher who once supervised that teacher also observes the process, so that dual supervision is maintained (p.389); and, as of the 2010 preface, there were eight graduates (p.1). The commentary summarizes the principle of treatment as follows.

"It was never possible in the first place to respond [to patients] by memorizing Sasang medical knowledge or the manuals of psychoanalysis. Therefore … there is no other way than for the analyst himself to become the instrument."

— Kang Yong-hyuk, 『四象心學』 Sasang Simhak, 2010, p.365

Contemporary psychotherapy research supports the importance of the therapeutic relationship itself. A meta-analysis of 79 studies reported a consistent, moderate relationship between the therapeutic alliance and outcome, and a systematic review of psychological therapies for psychosis (24 studies, 1,656 participants, 13 of them meta-analysed) likewise reported correlations between alliance and reduction in overall symptoms of r=.29 for client ratings and r=.24 for therapist ratings. What these results support extends only to the point that the therapeutic relationship is associated with outcome. They are not evidence that five to ten years of self-analysis or dual supervision improves the alliance or the outcome, and within the material reviewed for this paper no study was found that evaluated such an effect.

6. Safety boundaries: the risks Taeyul recorded himself

Taeyul's records contain a number of boundaries he drew for himself [Taeyul's record]. Of a case he reported in 1992, he wrote that "analytic treatment of schizophrenic patients generally carries great risk, so although the result was good, it was a dangerous attempt" (Lecture Collection p.413). In the 1996 case, he withheld causal analysis and changed the goal to ego strengthening (p.415), and because of the risk of transference he had a guardian present at every interview with the female patient (p.418). Regarding countertransference, he warned that "marrying a patient, or drawing the patient into one's own sphere of life, in order to cure that patient is not the performance of one's function as a physician, and is in part a desire of the mind (心慾)" (p.418).

His stance on medication cannot be reduced to one side. In the 1996 case, he stopped the previous treatment but had the patient keep the medication from the psychiatric outpatient clinic and permitted "limited use when necessary" (p.415) [Taeyul's record]. The transcriber's summary includes treating the illness with medicine in the first principle of interview-based treatment (p.239) [transcriber's summary], and another lecture transcript reports that for Soeum and Soyang persons, medication must also be adjusted alongside the interview (p.231) [lecture transcript]. At the same time, Taeyul criticized the excessive administration of herbal medicine for illnesses that had not become fixed in the body type (p.418) [Taeyul's record]. These records reflect the judgement of one clinician in the 1990s. The current standard of care for schizophrenia includes antipsychotic medication, and adjustment of psychiatric medication should, as a rule, be undertaken in consultation with the prescribing psychiatric team.

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4. Cross-Reading

The reconstructed content, arranged together with its source layers, is summarized below.

As the table shows, the principles of constitutional determination recur across several records; the training structure and the recording code depend on the commentary; and the first interview, the treatment contract, and diary analysis depend on a single case. Discontinuation criteria and outcome evaluation are absent. The axis shared by the classical text and the Sasang Simhak literature is that examining one's own mind (責其心) is taken as the direction of treatment. Viewed through the interpretive framework of Part 1, this approach attends first to temperament and patterns of relationship, yet Taeyul himself included the treatment of medication and the body in the first principle.

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5. What Remains Unknown

The 1996 case record contains a description of short-term improvement. An interim entry made one month after the first interview states that "the difficulties in daily life caused by the auditory hallucinations have decreased markedly" (p.417). No standardized rating scale was used, however, and the source material does not show whether the planned three years of interviews were carried out or what the long-term course was. Taeyul himself characterized this record as a report of the "possibility" of improvement through interviews alone, without medication.

There are also gaps in the procedures. No explicit provision for discontinuing interviews, no specification of the length, format, or method of review of the diary, and no record of assigning dream recording to patients as a task were found. In the four-position code, the rules of the slash notation and its correspondence with the 1996 notation could not be confirmed. All 36 pages that were initially unreadable have been restored by collation with digital manuscripts of the same lectures. The procedures reconstructed in this paper rest on the published records of a single school and have never been externally validated.

The design questions to be addressed in Part 4 are as follows.

1. Can the notation rules of the four-position code be settled, and what level of agreement is obtained when two or more raters assign codes independently?
2. Can diary records be standardized in a format that separates "observed statements" from "the therapist's interpretation"?
3. With what scale should the stabilization of hangsim be tracked (in parallel with anxiety and depression scales)?
4. Separately from the principles of initiating intervention and consent, how should criteria for discontinuation and referral be set in line with current standards for collaborative care with psychiatry?
5. Is it possible to examine whether therapist case review is associated with indicators of the therapeutic alliance?

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6. Source Citation Cards

The "Text verified" field on each card indicates the range that this paper actually collated. Because no formal quality appraisal was performed, no certainty-of-evidence grades have been assigned.

Source 1 [KM]

• Source: 『동의수세보원(東醫壽世保元)』 Dongui Suse Bowon, 1901 Sinchuk edition: "On Nature and Destiny" (性命論) [1-37], "On Broad Relief" (廣濟說) [16-4], "Discriminating the Four Constitutional Types" (四象人辨證論) [17-21]
• Author/Era: Yi Je-ma (李濟馬), Joseon dynasty (1901 Sinchuk edition)
• MEDICLASSICS: mediclassics.kr/books/182/volume/1#content_39 · volume/4#content_205 · #content_246
• Text verified: Direct collation with the original text | Study type: Classical text
• Key point: 責其心 (holding one's mind to account), helpers assigned to each stage of life, stabilization of the constitution-specific hangsim.

Source 2 [KM]

• Source: 『四象心學』 Sasang Simhak
• Author/Year: Kang Yong-hyuk, Daesung Medical Publishing, 2010
• Location cited: Preface pp.1, 3; chapter on analytical psychology p.319; chapter on self-cultivation pp.351, 353, 354, 365, 385, 389; chapters on physicians, "On Broad Relief," and "Discriminating the Four Constitutional Types" pp.399, 424–425, 429
• Text verified: Collated against the full text (author's library corpus) | Study type: Commentary by a school
• Key point: The four-position code and the time for change in each position, principles of constitutional determination (quoting Taeyul), self-analysis training and dual supervision, "the analyst himself becomes the instrument."

Source 3 [KM]

• Source: Taeyul (Kim Do-sun), "Sasang Simhak Simple-Type Schizophrenia Case I" (사상심학 단순형 정신분열 Case I), online study circle post #1272 (August 1996)
• Location cited: Edited compilation "Taeyul (Kim Do-sun) Lectures on Sasang Simhak," pp.413–418
• Text verified: Collated against the scanned and transcribed version | Study type: Structured online case record (short-term interim record)
• Key point: First-interview format, treatment contract, the headings "diary analysis: problems / problem analysis / ego-strengthening points," the goal of ego strengthening, recorded risks.

Source 4 [KM]

• Source: Transcript of Taeyul's lecture "Advanced Hwakchungnon: Friendship, Factions, Affairs, and Dwelling" (확충론 심화: 교우·당여·사무·거처) and the transcriber's summary of main points at its end
• Location cited: Lecture Collection pp.231, 238–239
• Text verified: Collated within the legible sections | Study type: Lecture transcript and transcriber's summary
• Key point: The three principles of the interview, the four stages of treatment (original notation "individualization"), the technique of allegory and metaphor, the principle of "pretending not to know," concurrent medication for Soeum and Soyang persons.

Source 4-1 [KM]

• Source: 「심학공부 (녹취)」 "Study of Simhak (transcript)" — digital manuscript (docx) of a transcript of Taeyul's lectures, held in the author's library
• Location cited: Corresponds to pp.206–207 of the edited Lecture Collection (these pages of the compilation could not be read by OCR and were restored by collation with the digital manuscript)
• Text verified: Collated against the full digital manuscript | Study type: Lecture transcript
• Key point: Sasang is "inserting a filter between my five sensory nerves and the cerebrum," that is, "a filter with which one can check one's own deviation."

Source 5 [KM]

• Source: Taeyul's lectures and posts (complete translation of and commentary on Hwakchungnon, the advanced Hwakchungnon lectures, posts on the Taeyang person, "On Broad Relief," and "Discriminating the Four Constitutional Types," and the online lecture "Subjective and Objective: Simhak Training" (주관·객관, 심학 수련))
• Location cited: Lecture Collection p.55 (the question against diagnosis by medication trial; observer bias), p.71 (deferral of case presentation), p.213 (stating the grounds for a determination), pp.424, 430 (the principle of initiating intervention; coping over causes), p.504 (the difference that questioning style makes to answers)
• Text verified: Collated within the legible sections | Study type: Lecture records and posts
• Key point: Constitutional determination as interview-based inference, the statement of grounds, the principle of initiating intervention and consent.

Source 6 [WM]

• Source: The delayed, durable effect of expressive writing on depression, anxiety and stress: A meta-analytic review of studies with long-term follow-ups
• Author/Year: Guo L, 2023, Br J Clin Psychol (PMID 36536513)
• Text verified: Abstract | Study type: Meta-analysis
• Key point: 31 RCTs, 4,012 participants, g −0.12 (−0.21–−0.04), delayed and durable effect.

Source 7 [WM]

• Source: Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review
• Author/Year: Martin DJ et al., 2000, J Consult Clin Psychol (PMID 10883561)
• Text verified: Abstract | Study type: Meta-analysis
• Key point: 79 studies; a consistent, moderate relationship between alliance and outcome.

Source 8 [WM]

• Source: Systematic review and meta-analysis of therapeutic alliance, engagement, and outcome in psychological therapies for psychosis
• Author/Year: Bourke E et al., 2021, Psychol Psychother (PMID 33569885)
• Text verified: Abstract | Study type: Systematic review (24 studies, 1,656 participants), of which 13 studies were meta-analysed
• Key point: Alliance and reduction in overall symptoms, r=.29 (client ratings) and .24 (therapist ratings).

Source 9 [Author's previous work]

• Source: Sasang Simhak clinical series, Part 1: "What Do Constitutional Prescription and the Analysis of Temperament and Emotion Attend to First?"
• Author/Year: Choi Jang-hyuk, 2026, Sowonjae (forthcoming)
• Study type: Narrative literature review
• Key point: A comparison of the focus of two bodies of clinical literature; the interpretive framework of things, body, and mind (物·身·心).

Source 10 [Author's previous work]

• Source: Returning to Sincerity (反誠) and Differential Completion: The Structure of Self-Cultivation in the Banseong Admonition of Gyeokchigo (格致藁), Compared with Jung and Zhu Xi
• Author/Year: Choi Jang-hyuk, 2026, Sowonjae (sowonjae.dongjedang.com/post/2026-06-23-banseong-differential-completion/)
• Study type: Theoretical comparative study
• Key point: The theoretical background of the structure of self-cultivation.

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Choi Jang-hyuk | Doctor of Korean Medicine · Director, Dongjedang Korean Medicine Clinic · Method: reconstruction of clinical method from the documentary record (page-level collation of Sasang Simhak and the Taeyul lecture collection)