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Published Online:https://doi.org/10.1176/ajp.111.5.343

Since improvement under psychotherapy is not a unitary phenomenon, progress in studying the effectiveness of psychotherapy depends on the use of carefully defined and generally agreed upon criteria of improvement. In the present state of knowledge such criteria must be based on value judgments by the patient, and by persons with whom he interacts. It is suggested that the criteria comfort and effectiveness represent these values. Means of measuring them are described and problems connected with the measures considered. Some implications of the viewpoint that improvement must be evaluated in terms of underlying personality changes are discussed. A simple measure of self-awareness is described which may be a possible indicator of certain such changes.

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