Countering perfectionism in research on clinical practice II: Retrospective analysis of treatment progress

A simple correlational study is described which has methodological advantages, when compared with an equivalent manipulative (i.e., quasiexperimental) research design, for examining exploratory questions about treatment outcome. These advantages stem from the fact that retrospective designs, when compared with prospective ones, are much less likely to involve ethical problems due to offering relatively ineffective or unnecessary treatment, and less likely to involve confounds from newly hypothesized differential expectations about treatment. Based on Millon Clinical Multiaxial Inventory (MCMI) scale scores, clients with high levels of histrionic or narcissistic (and possibly also those with antisocial, compulsive and paranoid) personality traits seemed to profit more from RET than those without such traits. Clients with high levels of schizoid, avoidant, and schizotypal traits (and probably also clients with strong passive-aggressive traits, and possibly also clients with strong dependent and borderline traits) seemed to profit less from RET than those without such marked traits. We have previously shown that the relatively healthy personality traits and disorders are associated with global self-upping and the relatively sick ones with global self-downing, as well as contrasting patterns of positive and negative reactions to stressful events. Our findings here support the concept that clients who consistently handle life situations well will tend to progress most rapidly in therapy, and those who generally handle life situations badly will tend to progress slowly. Personality traits may be especially significant markers for therapeutic attention to problems stemming from global self-rating. Expectations based on the severity of global self-upping and/or self-downing may be good predictors of therapeutic progress. In contrast, expectations about RET outcomes based on severity of distress or neediness will probably be less accurate.Dr. Russell C. Leaf is Associate Professor of Psychology at Rutgers. He also directs a research project at the Institute for Rational-Emotive Therapy, in collaboration with the four other authors of this article, on the relationships between intake personality and mental health. He is an Institute Fellow and Supervisor, and previously served as a staff therapist and as the Institute's Director of Clinical Evaluation.Albert Ellis is President of the Institute for Rational-Emotive Therapy.Roslyn Mass is Professor at Middlesex County College. She is in charge of data processing and analysis for the collaborative research of this authorial team, and is a Fellow of and previously served as Administrative Director of the Institute for Rational-Emotive Therapy.Raymond DiGiuseppe is Associate Professor of Psychology at St. Johns and Director of Research and Director of Training at the Institute for Rational-Emotive Therapy.Diane Alington is Assistant Director and a member of the core faculty of the Institute for Health, Health Care Policy and Aging Research at Rutgers, where she conducts a research program on sex differences in adult development.