This study compares the effects of exploratory, insight-oriented (EIO) and reality-adaptive, supportive (RAS) forms of psychotherapy on a sample of 95 schizophrenic patients. Analyses of 2-year outcomes revealed a complex interaction between the type of psychotherapy provided and the domain of psychopathology affected. RAS psychotherapy exerted clear preferential effects in the areas of recidivism and role performance. The EIO psychotherapy exerted preferential, albeit more modest, action in the areas of ego functioning and cognition. Overall, however, the magnitude of the differences was low. The results highlighted the need for more focused studies of subgroups, and of process and contextual influences on outcome.

This article describes a 2-year, multi-hospital study on the effects of psychotherapy for nonchronic schizophrenic patients. The design and methods used to evaluate the relative benefits of exploratory, insight-oriented (EIO) psychotherapy and reality-adaptive, supportive (RAS) psychotherapy when both are provided by experienced therapists against the backdrop of good hospital and psychopharmacological management are presented. Similarities and differences between the two therapies and the therapists are outlined. Special attention is given to the problems in implementing research on long-term psychotherapy. Finally, the strengths and limitations of the present study are discussed.

Fifty-nine seriously ill female psychiatric patients were randomly assigned, after 2-6 weeks of inpatient evaluation, to an inpatient or day service, where they were evaluated, along with a control group of 34 "usual" day hospital patients, for up to 24 months. The data indicate that for the range of patients studied day treatment is, on the whole, superior to inpatient treatment in five distinct areas: subjective distress, community functioning, family burden, total hospital cost, and days of attachment to the hospital program. The findings of other controlled studies are confirmed and extended to include previously unreported outcome dimensions and a broader sociocconomic population.

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The tone of voice in which therapists spoke about their alcoholic and/or drugabusing patients was employed to predict the tone of voice in which these same therapists would speak to these same patients. Clips of speech ranging from 10 s to 1 min were content filtered and rated by judges. The results of zero-order correlational analysis, multiple regression, and canonical correlational analysis all showed clearly that predictions of therapists' tone of voice could be made with discriminant as well as predictive validity. Predictions were not only very significant statistically, but of practically meaningful magnitudes. Therapists who spoke about patients in a coldly autocratic way tended to speak to these patients in a coldly professional way. Therapists who spoke about patients in a warm and caring way tended to speak to these patients in a warm and honest tone of voice.