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TMatch: Matching Clients to Therapists
Based on Client Conscientiousness

Short Restatement of Matching Recommendations

Conscientiousness (C) measures organization, persistence in pursuing goals, focus, self-discipline, and motivation. The matching recommendation is that clients low on C should be matched to therapy that requires little hard work, has little discomfort, doesn't include homework, has a high amount of structure, and emphasizes behavior therapy and skills training.

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: Hard Work and Discomfort

Hard work not required and discomfort not occurring was assessed with the following two questions:

  1. How hard do clients have to work to obtain good results from your therapy?
  2. In general, how confrontational is your therapy?

Therapist Assessment: Homework

Homework not included in therapy was assessed with the following two questions:

  1. To how many of your clients do you assign homework?
  2. When you assign homework to a client, how often do you do this?

Therapist Assessment: Amount of Structure

Amount of structure in therapy was assessed with two questions:

  1. To what degree is your usual method of therapy structured?
  2. To what degree is what happens during your therapy planned?

Therapist Assessment: Behavioral Therapy and Skills Training

This assessment was based on how therapists rated the help-way [clients] develop new skills or learn new ways to behave in the outside world from the Help-Ways questionnaire.

Future Use of Conscientiousness for Matching

Results of Study: Client Assessment

I am going into more detail in this section than for other sections on this web site, because I think something is wrong with the NEO-FFI in this assessment area. For all clients, including pilot testers, on the scale of 1-5, Conscientiousness had a mean of 2.50 (sd = 1.17). Thus almost all the clients had C between 1 and 4. Specifically, the participant clients had C's of 1, 1, 2, 3, 4, and 4. The pilot testers had C's of 1, 2, 2, 3, and 4. These low rating are very surprising, given that most of the clients seemed to be very conscientious people. For example, all the clients but one (including pilot testers) presently had or recently had full time jobs that required moderate to high conscientiousness. One client in the study, who works as a paralegal, and whom I personally know to be extremely conscientious, had a rating of C = 2. Another client in the study, who owns and manages her own clothing store, had a rating of C = 1. A third client, whose job is drafting, which requires great conscientiousness, had a rating of C = 1. The pilot tester with C = 1 works as a bookkeeper. One of the two pilot testers with C = 2 works as a 911 operator, and the other just received her BA in physics from a prestigious state university, and is now getting her Ph.D. at another prestigious university. All clients who were shown their ratings after taking the NEO-FFI thought that all the ratings made sense except for C, which they almost uniformly were surprised was so low. The part of the computer matching program that calculated C was thoroughly checked by doing ratings by hand for several clients, and it seems to be accurate. The cause of the problem is not known, but it is clear there is a problem. Perhaps the setting in which it is being used, which is in conjunction with other assessments, is causing some sort of interference. It is hard to believe that the NEO-FFI, which is a commonly used and tested instrument in psychology research, actually has a defect of this magnitude.

Results of Study: Therapist Assessment of Hard Work and Discomfort

Almost all therapists self-assessed that a fair amount of hard work was required by their therapy. The question about confrontation was used in this context because it was included for other assessments in TMatch, but it is obviously only indirectly at best related to discomfort. Therefore, the assessment of hard work and discomfort required was not very successful in this first version of TMatch.

Results of Study: Therapist Assessment of Homework

The questions about homework did seem to differentiate therapists effectively. They both had means close to 4, with fairly high standard deviations.

Results of Study: Therapist Assessment of Amount of Structure

The direct question about amount of structure in therapy did produce some useful variability, although therapists tended toward believing their therapy had relatively low amounts of structure. The qualititative part of this study indicated that a problem with this question was that the term "structure" is not clearly defined or understood. People have an immediate reaction to this concept, but on deeper examination, are not in agreement as to what it means. The question about how much therapy was planned ahead was not very useful, as there was a strong tendency for therapists to think that they did not plan where their therapy was going ahead of time, and the level of planning ahead is only indirectly related to structure anyway.

Results of Study: Therapist Assessment of Behavioral Therapy and Skills Training

Considering that this assessment was based on the rating of one of "help ways," it was remarkably successful. On its possible order rating of 1-7, the mean was 3.84, with sd = 2.00. This shows the utility of trying to use questions for many different purposes in a multiple-criteria matching system.

Results of Study: Matching Success

Because of the problems in the client assessments, matching success could not be analyzed.

The Next Step for Matching Based on Conscientiousness

This matching criterion should not be used again until either the problem with the client assessment is determined, or another method of assessing client Conscientiousness is found.