The active, and sometimes It provides a balanced, heated, controversy between objective, and informative look at advocates of these two modes of both sides of one of the most controtherapy has raged despite a versial issues in psychiatry today, shortage of solid information. R. Bruce Sloane, M.D., is But now we have the results chairman of the Department of of a rigorously controlled study Psychiatry, School of Medicine, with actual patients, experienced University of Southern California, therapists, and frequent Commonwealth Fund.

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Three behavior therapists and three analytically oriented psychotherapists treated a total of CO neurotic outpatients for 4 months. Measures of Rogers-Truax factors, nonlcxical speech characteristics, therapist informational specificity, and a content analysis of therapist activity were taken from recordings of the fifth interview. Therapists rated their feelings toward their patients, and patients completed the Relationship Questionnaire and the Lorr Inventory. In psychotherapy, patients who were most liked by their therapists and those with greater total speech time showed greatest symptomatic improvement. Patients who used longer average speech durations improved most in both treatments. It was concluded that patient improvement was more a function of patient characteristics than of specific therapist interventions.Controversy over the effective ingredients of psychotherapy has long been a characteristic feature of the field. Clinical beliefs predominate since research studies have not isolated those therapist behaviors that lead to improved outcome with sufficient consistency or precision. Even the apparently wellestablished triumvirate of accurate empathy, unconditional positive regard, and therapist self-congruence is currently undergoing critical reevaluation (Bergin & Suinn, 1975;Mitchell, Truax, Bozarth, & Krauft, 1973).The question is confounded by the plethora of different therapies, each with idiosyncratic treatment strategies. Do the different therapies share some common features that lead to success regardless of theoretical differences? Or has each grasped some unique therapeutic truth sufficiently potent by itself to produce improvement?We found behavior therapy and analyti-

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Ninety-four psychoncurolic or personality disordered patients received 4 months of analytically oriented psychotherapy, behavior therapy, or waiting list treatment. Neither active treatment was more effective than the other with any type of symptom (including affective ones), although both were more consistently effective than the wailing list. With psychotherapy, relatively greater success was associated with less overall pathology on the Minnesota Multiphasic Personality Inventory and higher socioeconomic status. Psychotherapy was least effective with patients who scored high on the Hysteria and Psychopathic Deviate scales. There was also a strong but nonsignificant trend for more improvement in psychotherapy patients who were younger, female, married, later born, more intelligent, and from smaller families. In contrast, behavior therapy was more effective with those who scored high on the Hysteria and Mania scales and seemed to be effective with a broader range of patients.