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TMatch: Client/Therapist Matching
Based on Client Agreeableness

Short Restatement of Matching Recommendations

Agreeableness (A) reflects friendliness, compassion, cooperativeness, and, in the opposite direction, antagonism and hostility. The matching recommendation is that clients low on A should be matched to therapy that has a relatively high focus on symptoms and support, and has a low level of direct confrontation.

Client Assessments

Clients were assessed on the five domains of Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness using the NEO Five Factor Inventory, as described in the introduction page to matching using 5-factor personality theory.

Therapist Assessment: Focus on Symptom Reduction

Focus on symptoms was assessed with two questions:

  1. To what degree do either of these descriptions describe your therapy? (Straightforward, practical, symptom-focused, educational, and supportive vs. Provocative, imaginative, involves novel thinking and experiences, focuses on self-exploration and discovery, and/or involves paradigm shifts).
  2. How much does your therapy focus on alleviation of symptoms, vs. on depth (underlying causes of problems)?

Therapist Assessment: Focus on Support

Focus on support was assessed primarily through how therapists' rated the help-way [clients] develop more hope that they can solve their problems from the Help-Ways questionnaire.

Therapist Assessment: Level of Confrontation

Level of confrontation was assessed by one direct question: In general, how confrontational is your therapy?

Future Use of Agreeableness for Matching

Results of Study: Client Assessment

For all clients, including pilot testers, on a scale of 1-5, Agreeableness had a mean of 2.67 (sd = 1.23). Despite the slightly low mean, there were only two of the six participant clients who were low enough on A to trigger the matching recommendations, which were only for clients low on A (assumed to mean less than 3). No clients in the study had extremely low ratings on A, which would have created a better test of this matching criterion.

Results of Study: Therapist Assessment of Focus on Symptom Reduction

As discussed in the section on "5-Factor Openness," both of the questions in this section worked to some degree, but need improvement. The first question in particular should be separated into components and somewhat reworded to try to reduce the positive connotations on the side of "imaginative," "novel," and "paradigm shifts," which seem more positive than "straightforward" and "practical."

Results of Study: Therapist Assessment of Focus on Support

Therapist assessment of focus on support in TMatch did not work well. This is a difficult area of assessment, since it would be expected that therapists are not vastly differentiated on this quality, but instead vary the amount of support they give depending on the needs of their clients. If therapists do vary in general on this quality, it would take several studies just on this subject to determine this and to create a valid assessment instrument.

Results of Study: Therapist Assessment of Level of Confrontation

This assessment, although made with just one question, did appear to work well, and therapists were different in their self-assessments on this aspect of their therapy.

Results of Study: Matching Success

There were too few clients with low ratings (and no clients with very low ratings) to make any determinations on the success of this matching criterion.

The Next Step for Matching Based on Agreeableness

It would be worth trying this matching criterion again with clients with very low levels of Agreeableness. The suggestions for focus on symptom reductions and low levels of confrontation for these clients are certainly worth exploring further. The suggestion for high levels of support for these clients would only be worth trying again in the context of client-therapist matching if some evidence for, and an assesment method for, therapist differences on this quality could be found.