In Brief

Clinicians can successfully predict which patients will benefit from psychotherapy and which ones won't, according to recent research published in APA's Journal of Consulting and Clinical Psychology (Vol. 67, No. 5, p. 698-704).

The prediction model—patient profiling—used in the study can help insurers and therapists make decisions about treatment, according to the researchers, Scott Leon of Northwestern University Medical School; S. Mark Kopta, PhD, of the University of Evansville; and Kenneth Howard, PhD, and Wolfgang Lutz, PhD, also of Northwestern University.

Patient profiling, devised by Howard, uses measures of patients' psychological and life functioning, treatment expectations and history before and during treatment to statistically predict their responses to psychotherapy. In the study, the researchers applied the model to 890 outpatients who received psychotherapy through managed mental health-care programs. Patients were assessed by a battery of scales developed by Compass Information Systems.

Howard's model accurately predicted treatment outcomes—both positive and negative—for about 75 percent of the patients. The rest of the sample failed to match expectations, not responding to treatment as well as predicted or responding better than predicted.

The profiling model best predicted treatment responses for patients with relatively high psychological functioning but low romantic satisfaction. By comparison, patients with significant psychological impairment and higher satisfaction with their partners were harder to peg.

Patients who benefited the most from treatment tended to have an optimistic outlook and relatively stable levels of functioning in work, family and self-management. They also tended to expect that psychotherapy would help, and were less likely to have a previous history of psychological problems and psychotherapy.