This study investigated whether clients' pretherapy scores on affiliation-hostility and dominance-submission interpersonal dimensions would be related to outcome of therapy. Fiftyfive outpatient clients who received an average of 24 sessions completed the Interpersonal Checklist (ICL) both at the beginning and at the end of therapy. Successful therapy clients, as rated by both therapist and client, were significantly more affiliative (less hostile) than were less-than-successful therapy clients both before and after therapy. Seventy-two percent, or 21 out of 29, of clients whose predominant pretherapy interpersonal stance was characterized as affiliative had successful outcomes, whereas ony 38% (10 out of 26) of clients whose predominant pretherapy interpersonal stance was characterized as hostile had successful outcomes. No significant differences were observed between outcome groups on the dominance-submission dimension either before or after therapy. However, as expected, a significant number of successful therapy clients showed a pre-versus posttherapy shift in their interpersonal stances from submission to dominance. The results highlight the reported difficulty of short-term dynamic psychotherapy with hostile clients and suggest the importance of assessing clients' pretherapy interpersonal attitudes as one influence on therapeutic process and outcome.
Client Characteristics and Psychotherapy OutcomeDecisions regarding clients' appropriateness for individual psychotherapy are a common part of clinical activity. Psychological assessments often contain a clinician's perspectives regarding a client's suitability for and probable responses to psychotherapy, and recommendation whether the client should receive psychotherapy or drjg therapy is often made. These decisions occur despite the evidence that attempts to predict psychotherapy outcome based on pretherapy client characteristics are either only modestly successful or disparaging (