Associate Professor Purdue University West Lafayette, Indiana
Cognitive behavioral interventions emphasize the importance of tracking symptom change in treatment. Considering personality pathology’s prevalence among clinical populations and its negative impact on treatment outcomes, it is particularly fruitful to track personality functioning. Evidence suggests that clients report robust changes in personality towards more adaptive levels quickly into treatment, but these studies are often limited by the sole reliance on self-report. The present study examined client and therapist ratings of clients’ personality traits using a naturalistic dataset of 128 client-therapist dyads (3,440 observations) engaged in cognitive behavioral interventions. Specifically, we examined agreement in personality ratings from the first four time points (taken at around one month intervals), as well as whether this agreement (or lack thereof) might relate to important treatment outcomes, such as client engagement, attendance, and symptom change. The results showed meaningful fluctuations in treatment, particularly for openness to experience and neuroticism. Agreement at the initial session was related to overall client engagement (r = .21), as well as how likely the therapist-client dyad agreed at subsequent sessions (rs ranged from .50 to .55). Agreement after one month of treatment was related to percent of sessions ultimately attended by the client (r = .19). Linear regression analyses indicated that, after one month of treatment, client-therapist agreement significantly predicted clients’ general symptom improvement (outside of just personality functioning) throughout interventions. Agreement after roughly three months of treatment was a significant predictor for the number of sessions the client attended. Results confirm that investigating personality traits can provide important information regarding clients’ overall outcomes in cognitive behavioral therapies. Agreement between client and therapist can also predict various outcomes.
