Psychotherapy Outcome as a Function of Therapist–Patient Matching on Selected Variables

This study tested the assumption that matching psychotherapy approach to theory-relevant patient characteristics would result in improved treatment outcome. Two patient dimensions were identified from eclectic theory as contributing to the relative effectiveness of several types of treatment among seriously disturbed patients: style of psychological defense and reactance potential. These variables were studied in a sample of psychiatric inpatients who were admitted to a teaching hospital for short-term care and treated in individual psychotherapy by therapists who used procedures varying in directiveness and focus. Outcome was assessed by three independent sources: therapist discharge ratings of global improvement; pre- and posttreatment patient ratings on a standardized symptom index; and nurses' ratings of ward behavior at the beginning and end of treatment. Compatible matches between patient defensive style and internal–external focus of therapist approach was a significant predictor of treatment outcome. Contrary to prediction, matching patient reactance potential to therapist directiveness did not affect outcome.