This comprehensive analysis addresses the United States' alarming lack of preparedness to respond effectively to a massive disaster as evidenced by Hurricane Katrina. First, a timeline of problematic response events during and after Hurricane Katrina orients readers to some of the specific problems encountered at different levels of government. Second, a list of the "Dirty Dozen"--12 major failures that have occurred in prior disasters, which also contributed to inadequate response during and after Hurricane Katrina--is presented. Third, this article encourages expanding psychology's role beyond the treatment of trauma to encompass disaster planning and mitigation efforts from a broader public health perspective. Finally, areas for important interdisciplinary research in human behavior that will influence our nation's overall preparedness for future catastrophes are identified, and ways psychologists can become personally involved beyond treating casualties are discussed.

Reviews the emergence of research on fitting treatment procedures to the unique needs and proclivities of patients. Traditional research on efficacy of psychotherapy focuses on the role of interventions and theoretical brands, minimizing factors that cannot be randomly assigned. This line of research has not realized its initial and desired promise, perhaps because it fails to incorporate into the study of psychotherapy important and effective treatment variations that are associated with therapist and non-diagnostic patient factors. Contemporary efforts to “fit” treatments to patients emphasize the roles of interventions, participant factors, and contextual/relationship factors. For these complex interactions, any of which reflect factors that cannot be randomly assigned, randomized clinical trials (RCT) protocols are inappropriate as a “gold standard”. Several studies are presented which illustrate not only the predictive power of incorporating both treatment mediators and moderators into the realm of psychotherapy study, but the value of a multi-method approach to research. Converging studies moreover, provide a way to incorporate matching algorithms into decisions about assigning optimal treatments.

Over the course of 60 years of research, several personality traits have emerged as potential predictors of differential change in psychotherapy. Among them is the patient's coping style (CS), commonly distinguished between those who deal with change by looking inwardly (internalization) and those who deal with it outwardly (externalization). This study provides definitions of CSs, clinical examples, and frequent measures. We update a 2011 meta-analytic review that revealed a consistent interaction between CSs and treatment focus-symptom focus versus insight focus. The current meta-analysis of 18 studies revealed a medium to large effect (d = 0.60) and suggested that a symptom focus proves more effective for externalizing patient whereas an insight focus is generally more effective for internalizers. The article concludes with limitations of the research, diversity considerations, and therapeutic practices based on the meta-analytic results.

The fit of patient coping style and psychotherapy focus has been suggested as improving treatment outcome. This article reviews the definitions, measures, and previous research surrounding this hypothesis. An original meta-analysis of 12 carefully selected studies (N = 1,291 patients) resulted in a weighted, mean effect size (d) of .55 in favor of a fit between externalizing patients and symptom-focused treatment or, alternatively, internalizing patients and insight-focused treatment. This medium-size effect indicates that nondiagnostic patient factors, like coping style, are important considerations in the selection of effective therapies. Clinical examples and clinical recommendations are provided.

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