Fitting psychotherapy to patient coping style: A meta‐analysis

Abstract

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.

An Integrative Approach to Clinical Decision-Making for Treating Patients With Binge-Eating Disorder

“…In line with the findings by Beutler et al’s (2018b) meta-analysis on patient resistance, patients who experience low resistance to treatment are not likely to drop out of psychotherapy and may comply well with treatment recommendations and directives.…”

“…On the other hand, externalizing coping refers to traits of impulsivity, gregariousness, expressiveness, tendency to blame others, tendency to make external attributions of cause, and a need for action (Beutler and Clarkin, 1990). A recent meta-analysis showed a robust relationship between coping style and response to certain therapist stances (Beutler et al, 2018b). Patients with a more internalizing coping style tend to do better with insight-oriented therapy focuses on self-reflection and on interpersonal issues.…”

“…Patients with a more internalizing coping style tend to do better with insight-oriented therapy focuses on self-reflection and on interpersonal issues. On the other hand, patients with a more externalizing coping style have better outcomes with therapists who focus on skills-building and symptoms (Beutler et al, 2018b). Very little research exists on the coping styles of those with BED, which would be useful to inform optimal therapist responsiveness.…”

“…We do so to characterize those with BED on the six patient domains that are related to treatment processes and outcomes. These domains were identified by Harwood et al (2011) and have received empirical support as predictors of patient outcomes (Beutler et al, 2002, 2011, 2018a,b; Beutler and Castonguay, 2006). We hypothesize that: (1) patients with BED will demonstrate higher functional impairment compared national and local normative samples; (2) the BED sample will have lower levels of social support and interpersonal functioning compared to non-clinical groups, but higher levels compared ED clinical samples; (3) those with BED will have greater comorbidities and complexity of concurrent disorders and higher self-reported problems with substance-use compared to the general population, but lower levels compared to ED comparison groups; (4) patients with BED will have higher indices of internalizing coping style relative to a normative non-clinical sample (we do not make specific hypotheses about externalizing coping style); (5) the BED sample will score significantly lower than non-clinical populations and other ED groups on measures of resistance ; and (6) those with BED will score higher on measures of subjective distress compared to normative samples, but will score lower than other ED groups.…”

Tratamientos Psicológicos Personalizados: Orientaciones Clínicas

“…A r t í c u l o s (Beutler, Kimpara, Edwards y Miller, 2018). Cabe señalar que los estilos de afrontamiento no conllevan necesariamente la expresión de psicopatología; no obstante, si el estilo de afrontamiento se vuelve extremadamente prominente, variable o rígido puede facilitar la aparición de psicopatología .…”