Interaction of therapeutic attitudes with severity of clinical diagnosis

Investigated whether therapeutic processes, measured by self-reported attitudes of therapists, are differential or generalized; i.e., whether particular types or all types of patients benefit from a given level of a professed technique. Three therapeutic variables (empathic warmth, directiveness, and uncovering), identified by factor analysis, were studied in interaction with two levels of clinical pathology. A total of 161 patients were seen in psychodynamically oriented individual psychotherapy by 22 therapists. Independent ratings of global improvement were made. Results indicated that high scores on empathic warmth and uncovering appear to be more helpful for patients with neurotic and personality trait disorder diagnoses than for patients with borderline and psychotic diagnoses. Low scores on directiveness seemed to be associated with effectiveness in a more general way (across diagnostic groups). For the most part, reference to therapeutic attitudes as helpful or harmful must take into account the particular diagnostic groups that are being treated.