Development and application of criteria for classes of psychotherapy based on patients' requests for service

Discrepancy frequently exists between the perspectives of psychotherapists and their patients about what problems and which patients are suitable for psychotherapy and how psychotherapy should be conducted. Lazare et al.'s (1972, 1975a) negotiated 'customer' approach attempts to correct this deficiency by providing mental health services that more fully take into account the specific service requests of patients. Lazare's 14 identified services were applied to develop profiles of each of four service types, including two classes of psychotherapy. Applying the criteria developed, 52.6 per cent of patients evaluated could be classified into one of four classes of service. Only two patients presented a pattern of service requests consistent with a broadly defined supportive psychotherapy. The three largest patient groups were then compared with respect to several classes of variables. Major differences were found between the non-psychotherapy group and the two psychotherapy groups, but not between the psychotherapy groups. Service requests of patients generally paralleled those perceived by the interviewers.