Matching therapy interventions to patient predisposing characteristics based on principles of change: Good versus poor fits to treatment among U.S. and Argentine samples

The field of psychology has long debated what factors are responsible for eliciting change in psychotherapy. One argument posits that treatment techniques are the catalyst for change, whereas others insist that the therapeutic relationship or participant factors are responsible. Recently, some have suggested that all of the aforementioned variables must be considered in interaction with each other to fully account for change. This paper reviews the history behind psychotherapy research, identifies treatment, relationship, and participant factors that have been deemed important in producing change, and visits the notion of integration of factors as a new way to view treatment. The Systematic Treatment Selection (STS) model is introduced as a means of customizing therapy based upon an evaluation of patient predisposing characteristics and treatment techniques.;The current study sought to determine whether outcome was improved when research-informed principles of change are followed in providing treatment. Archival data from three research projects in the United States and Argentina (total n = 92) provided measures of the patient characteristics of resistance and coping style. Participants received at least 16 sessions of psychotherapy, which were independently rated on variables such as therapist directiveness and use of behavior versus insight focused techniques. Participants were determined to have received a "good" match or a "poor" match. Analyses sought to test the following hypotheses: (1) Participants with a good fit to treatment will experience lower depression scores than those with a poor fit; (2) Argentine participants will demonstrate the same benefits from good match as U.S. participants; and (3) A moderately high level of impairment is necessary to benefit from the matching dimensions.;ANCOVA techniques determined the following results: (1) Matching treatment to patient coping style results in improved outcomes; (2) matching treatment to patient resistance results in lower depression scores for Argentine participants, but not for U.S. participants; (4) matching treatment to patient coping style results in lower depression scores for U.S. and Argentine patients; (5) Argentine patients do not experience as much benefit from psychotherapy as U.S. patients; and (6) level of impairment does not appear to moderate the effectiveness of the two matching dimensions.