Introduction to special section on client-therapy interaction research.

The gap between intuition and research concerning the differential effectiveness of therapies is addressed in the current set of articles. Conceptual and methodological problems common to interactional research are discussed, and alternative research strategies are offered.

Client-treatment interaction in the study of differential change processes.

Research that combines correlational and experimental approaches in a search for aptitude-treatment interactions (ATI) is both inescapable and of potential benefit to the field. A number of epistemological and methodological issues regarding ATI research are discussed, ranging from the meaning of interaction to questions regarding the number of aptitudes and their types and the nature of interacting treatments. Despite the less than encouraging record of ATI research, it should not be abandoned, rather its purposes should be expanded. Instead of focusing on the pragmatic but hard-to-achieve goal of finding an optimal match between individual clients and specific therapies. ATI research should serve heuristic purposes. Theoretically derived and empirically tested interactions can clarify the change processes and mechanisms that make therapies differentially effective. Exploration of another type of interaction is recommended also: aptitude-outcome interaction (AOI), in which ostensibly identical therapies yield different outcomes through different mechanisms for different clients. The emphasis of AOI research is also more heuristic than pragmatic.

Identification of patients at risk for nonresponse and negative outcome in psychotherapy.

This study evaluated the use of pretherapy patient variables as correlates of 3 categorical types of outcome: negative response (negative change of more than 1 normative SEest on depression measure); nonresponse (change within +/- 1 SEest on depression measure); and positive response (positive change of more than 1 SEest on depression measure) to psychotherapy among 62 patients with major depressive disorder. By using 4 scales from the Brief Symptom Inventory, the Inventory of Interpersonal Problems, age, and sex, 75.8% of the Ss were correctly classified into the 3 groups. Negative responders were characterized by high levels of interpersonal difficulty and low levels of subjective distress. Nonresponders displayed moderate levels of both interpersonal difficulties and subjective distress. Positive responders displayed high levels of both interpersonal difficulties and subjective distress.

Interrelating research processes of process research.

Given the contextual boundedness of process variables, 3 assumptions implicit in present process research are questioned: Process variables (a) have fixed meanings, (b) discretely contribute to outcomes, and (c) have a decontextualized net worth, evaluated by their correlations with outcomes. From a systemic perspective, a conceptual framework is suggested that integrates both theory-driven and discovery-oriented strategies into a cyclical, ecologically oriented model. Experiments, observations of change events, and detailed descriptions partake in this cyclical model, informing and enriching each other. The core of this integration is a transactional conception that sees change processes as mutually defining rather than interacting with each other, thus leading to holistic examinations of changes of pattern in addition to patterns of change. The transactional core serves as the point of departure and home base for both theory-driven and discovery-oriented research strategies.