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One hundred and sixty-six studies are reviewed of predictions of outcome of individual psychotherapy with adult patients. Predictors arc classed as patient, therapist, or treatment factors; the number of predictors which were significant versus nonsignificant are tallied. By far, the largest number deals with patient factors-relatively few with therapist or treatment. Those patient factors which were most often significantly associated with improvement are psychological health or adequacy of personality functioning, absence of schizoid trends, motivation, intelligence, anxiety, educational and social assets, and experiencing (rated from early sessons). Therapist factors are experience, attitude and interest patterns, empathy, and similarity of patient and therapist. The treatment factors revealed one main trend: the number of sessions. The review ends with a methodological evaluation and a suggestion for crossvalidation of the main predictors.

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Tape recordings of 60 early sessions of psychoanalytically oriented therapy were rated on 110 process variables by three raters. The ratings were clustered and factor analyzed. Four factors were rotated and interpreted as (a) Patient Health versus Distress (largely a stable characteristic of the patient); ( 6) Optimal Empathic Relationship (primarily a therapist characteristic); (c) Active Directive Mode and (d) Interpretive Mode with Receptive Patient (the latter two a function of both participants). For 27 of the 30 patients, outcome ratings were obtained from the therapist (Patient Improvement and Success + Patient Satisfaction). Patient Improvement was not predicted by any process ratings. Success + Patient Satisfaction, on which women scored higher than men, was predicted by Patient Health versus Distress. Thus, patients rated in early sessions as healthy and low in distress had better prognoses. Optimal Empathic Relationship qualities related positively to Success in therapies low in Directive Mode, but for relatively Directive therapies, this relationship was negative. * i> < .05. ** p < .01. *** p < .001.

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