Matching therapists and milieus: effects on engagement and continuance in psychotherapy

Systematic analysis of interactions between 60 schizophrenic patients, their therapists, and different types of psychiatric milieu programs revealed that (1) therapists whose treatment orientation conflicted with that of the patients' milieu had significantly more trouble engaging and maintaining patients in therapy over the course of two years than therapists whose treatment orientation matched that of the milieu; (2) the harmful effects of such a mismatch on a patient could be largely eliminated if the therapist remained administratively uninvolved.