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Predicting the Outcome of PsychotherapyFindings of the Penn Psychotherapy Project
Lester Luborsky, PhD;
Jim Mintz, PhD;
Arthur Auerbach, MD;
Paul Christoph;
Henry Bachrach, PhD;
Thomas Todd, PhD;
Marilyn Johnson, PhD;
Marjorie Cohen;
Charles P. O'Brien, MD, PhD
Arch Gen Psychiatry. 1980;37(4):471-481.
Abstract
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• Our study of predictability of outcomes of psychotherapy used predictions of two kinds: (1) direct predictions by patients, therapists, and clinical observers; and (2) predictive measures derived from the same sources. Seventy-three nonpsychotic patients were treated in psychoanalytically oriented psychotherapy (mean, 44 sessions). Two thirds of the therapists were residents in psychiatry; one third were more experienced. The two main composite outcome measures, measured at termination, were Raw Gain (residualized) and Rated Benefits, which intercorrelated at .76. Most patients improved and showed a considerable range of benefits. The clinical observers' direct predictions of Rated Benefits were highest (.27, P <.05). The success of the predictive measures were generally insignificant, and the best of them were in the .2 to .3 range, meaning that only 5% to 10% of the outcome variance was predicted. The prognostic Index Interview variables did the best (eg, emotional freedom composite, .30; a crossvalidation for 30 patients was.39 (P <.05). Neither the therapist measures nor the early psychotherapy session measures predicted significantly. Reanalysis of the similar Chicago Counseling Center study, in our terms, showed a similar low level of prediction success, eg, adequacy of functioning, marital status match, and length of treatment predicted significantly in both studies.
Author Affiliations
From the Department of Psychiatry, University of Pennsylvania, Philadelphia; Dr O'Brien is also with the Drug Treatment and Research Center, Philadelphia Veterans Administration Medical Center. Dr. Mintz is now with Brentwood Veterans Administration Medical Center, Los Angeles; Dr Todd is now with Harlem Valley Psychiatric Center, Wingdale, NY; Dr Johnson is now with Rush University, Chicago; Mr Christoph is now at Yale University, New Haven, Conn.
Footnotes
Accepted for publication Nov 14, 1978.
Reprint requests to the Hospital of the University of Pennsylvania, 207 Piersol Bldg, Philadelphia, PA 19104 (Dr Luborsky).
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