[The initial patient-therapist relation as a predictor of the course of treatment. An empirical study of prognostic factors in psychotherapy].

This article presents the results of investigation of prognostic factors (in terms of the decision concerning indication and the course of therapy) that can be deduced from the initial diagnostic situation involving 739 patients and their therapists within the framework of the Berlin psychotherapy study. Four groups of predictors for the course of therapy can by identified. Of greatest value are a related group of factors that describe the readiness for therapeutic cooperation against a background of feelings of individual self-esteem. Another group of predictors signals an unfavorable course of therapy in the presence of social stress, social incompetence and disintegration combined with avoidance behavior and somatic demands for consideration. The next group of negative predictors includes evidence of anxious-distrustful avoidance of contact and simultaneous helplessness on the part of the patient. A final positive group of indicators is based on a positive evaluation of a biography that has given the patient positive relational experiences and supportive introjects. The complex of therapists' descriptions and patient evaluations confirms the therapists as prognostic experts but allows for the recognition of differentiation in the patients' judgments. The results are discussed from an interactional point of view and with regard to the congruence of the mutual offers made by patient and therapist.