A Letter to My Friend and Researcher Colleague, Professor Sy Entist

Abstract

In this letter—somewhat edited in the interest of confidentiality—I argue that divergence or dispersion is much more typical of psychotherapy outcomes in a sample of cases than convergence and communality. The typical outcome picture is that few patients show very considerable improvement, while some deteriorate and the majority are widely scattered in-between. This fact, that people are different, has wide implications for the way outcome research data should be represented and presented. As the patient and the therapist factors are partially confounded, a remaining interesting theoretical issue is how the responsibility for this variation should be divided between the patient and the therapist. There are indications that researchers—and therapists—so far have tended to underestimate the accountability of therapist factor.