PROBLEMAn important aspect of the operation of clinics which evaluate the probable response of patients to behavior therapy is the diagnostic interview of the patient by (usually) an experienced staff member. An attempt is made in such an interview to decide various quest:ons, such as the nature of the disabilities present, the need for further examinations or referrals, the wisdom of the referral to this particular clinic, the probable response of the patient to behavior therapy, the indicated major areas to work on in behavior therapy, the therapist most likely to be effective (of those available), etc. It is generally assumed that the interviewer elicits the behavior and information (conscious and unconscious) relevant to the above questions by inducing as much spontaneity in the patient as possible, despite the necessity for asking some direct questions; this assumption implies careful adjustment of the interviewer's behavior and verbalizations to those of each patient and also necessarily that the spontaneously behaving patient has a characteristic pattern of his own. The following explicit statement of how the interviewer is supposed to function in first contacts with a patient who needs behavior therapy was made by Saslow and Buchmueller(l): "He adjusts his speech and non-verbal activity to the patient's tempo, duration of utterance, and capacity for interruption, so that the patient is as comfortable as possible with him, especially in the first interviews". No data were presented to support the assertion that the interviewer or therapist does in fact behave as assumed. As has been convincingly demonstrated by Kelly and Fiske(2), strong confidence in predictions about human behavior may be inversely related to the measured validity of the predictions.We have therefore considered it necessary to examine the hypothesis that a diagnostic interviewer suits his behavior to that of the patients he examines, in the ordinary course of his work.
METHODThe patients interviewed were referred from various clinics at this medical center to a clinic for comprehensive medicine (Medicine D) described elsewhere@).Their disabilities could be single or multiple; they had different degrees of awareness of the reasons for being referred; they accepted referral in diverse ways; had varying attitudes towards behavior therapy and a wide range of probable responses to it; they differed in intellectual ability, and in many other ways. The usual procedure was as follows: Besides the regular diagnostic interviewer (a senior therapist), there were present 2 or 3 therapists-in-training (psychiatric residenta, medical internes, medical social workers, clinical psychologists, or senior medical students). The interviewer read aloud to the group the patient's clinic record, as rapidly as possible, in order to focus the patient's problems to some degree. He then left the room to meet the patient (who had an appointment in Medicine D made a few days earlier), returned with the patient, and introduced the patient to the group. He then turned...