Can patients' views of a therapeutic system predict outcome? An empirical study with depressive patients

Using the principles of brief therapy as developed at the Mental Research Institute (MRI) in Palo Alto, this study examined how patients viewed psychiatrists' and significant others' attitudes toward the severity of their illness, as compared with their own attitude, and whether these views were related to outcome. Forty-one depressive inpatients were asked a two-part question--Who regards your illness as being more severe: (a) you or your significant others; (b) you or your psychiatrist? Two subsamples of patients were identified: those who viewed psychiatrists' and significant others' attitudes toward the illness as similar (equally structured systems) and those who viewed them as dissimilar (differently structured systems). Both groups showed equal and significant improvement during hospital treatment; but the group that viewed the attitudes held by psychiatrists and significant others as dissimilar reported improvement after discharge.