A and B therapists in a therapeutic interview: A study of behavioral and attitudinal distinctions

The experiment investigated the relationship between psychotherapist's personal characteristics and the psychotherapeutic relationship. More specifically, the relationship between the AB dimension and some of the presumed correlates of therapy outcome were explored. The AB Scale consists of twenty-three items from the Strong Vocational Interest Blank (SVIB). The Scale differentiates those therapists who are more effective with schizophrenic patients (A therapists) and therapists who are more successful with neurotic patients (B therapists). It is the only instrument which predicts therapists' success. Based on prior research with the AB Scale and its' relationship to psychotherapy, three hypotheses were investigated. It is predicted with neurotic patients: (1) B therapists will be significantly more empathic, warm, and genuine than A therapists. (2) B therapists will be significantly more uncomfortable with their patients. (3) B therapists will have significantly more negative attitudes toward their patients than will A therapists. The Ss in this study were twenty-five fourth-year medical students who were undertaking their assigned fifteen-week rotation in the outpatient Psychiatry Department. They had all undergone the same amount of training in psychotherapy and they were assumed to be homogeneous in terms of psychotherapeutic experience. The therapists were classified as A and B on the basis of their responses to the AB Scale. Twenty-five out-patients who were classified as neurotics, were randomly assigned to these therapists. The initial interview was tape recorded. Immediately after the interview the therapist filled out the Patient Evaluation Questionnaire. This questionnaire contained three subtopics. (1) The therapists clinical assessment of the patient. (2) His personal judgment of the patient. (3) The therapist's reactions during the interview. Random segments of the recordings of the interviews were given to raters who rated each therapist on the degree of the therapeutic conditions: empathy, warmth and genuineness. The results of the study indicated that the AB Scale is not related either to the therapeutic conditions or to therapists' attitude or personal reactions during the interview. Consequently, all three of the hypotheses failed to receive confirmation. The results also indicated that conditions of greater empathy, warmth, and genuineness were related to positive attitudes by therapists toward their patients. It was concluded that the differential success of A and B therapists cannot be accounted for by differences between the two groups in their degree of empathy, warmth, and genuineness with neurotic patients. The question remains open as to whether A and B therapists are differentially empathic, warm, and genuine with schizophrenic patients. It was also concluded that while the AB dimension and empathy, warmth, and genuineness are related to success in psychotherapy these two are not related to each other. A logical explanation for this discrepancy is that the two sets of variables are independent sources of variance in therapeutic outcome. The finding of no relationships between therapists' attitudes in the AB Scale is not consistent with findings of previous studies. It was suggested that the differences in findings of the present study and previous ones may have their basis in methodological variations. In short, it was speculated that as one more closely approximates the therapeutic situation, AB differences in attitudinal reactions become more attenuated. These results, therefore, call the findings of prior studies into question. The finding that higher therapeutic conditions were related to positive attitudes by therapists empirically confirms for the first time the emphasis of other theories that a positive evaluation of a patient will be associated with positive intervention. Follow-up research would logically involve: (1) a replication of the present study with a group of schizophrenic patients included; and (2) the investigation of other therapy-relevant behavior by A and B therapists which may be related to their differential success with schizophrenic and neurotic patients.