Cluster analysis of patient reported psychotherapy outcomes

The purpose of the present investigation was to explore the patient's perspective of important psychotherapy outcomes. Eighty patients, following 25 sessions of dynamically oriented psychotherapy, were asked in writing to describe the most important changes they had received from psychotherapy. Ninety distinct changes were reported by this sample. A dissimilarity matrix of these changes was analyzed using hierarchical cluster analysis. The cluster analysis revealed four clusters: improved symptoms, improved self-understanding, improved self-confidence, and greater self-definition. Further, these four clusters formed two superclusters corresponding to improvements in symptoms and self-concept. The results of this investigation indicate that a complete outcome battery, designed to encompass all changes important to patients treated in dynamically oriented psychotherapy, should include not only symptom change measures, but also measures of change in self-concept.