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Therapists' attitudes and patients' clinical status. A study of 100 psychotherapy pairs.

One hundred psychotherapy relationships involving nine psychiatrists and 92 psychiatric inpatients were monitored over treatment periods of three months or longer, encompassing a minimum of 36 interviews. The data demonstrated a striking association between Self-report and psychotherapy supervisory measures of therapists' attitudes towards their patients and the patients' independently rated clinical status. Therapists' attitudes showed substantial variability over time, becoming more positive at times when patients improved and more negative when they regressed. While this study's design did not permit conclusions to be drawn as to whether shifts in therapists' attitudes were causes or effects of changes in patients' clinical status, the extent of their demonstrated interdependence clearly warrants that psychotherapy outcome research take careful account of the attitudinal set a given patient evokes in his therapist. A simple method of doing so is presented and discussed.