Miller (1991). The psychotherapeutic utility of the five-factor model of personality: A clinician’s experience

Trait

Treatment implications

Outcome implications

Neuroticism

Treatment for a client with a low score on this trait needs to focus on relatively isolated, self-defeating behaviour pattern or a strong emotional reaction to a recent stressor. Treatment for a client with a high score on this trait needs to focus on generic difficulties and clear and realistic treatment goals are imperative.

It is likely that clients with high scores on this trait will keep some form of trouble due to the high neuroticism. It is unlikely that the score of this trait will decrease significantly.

Extraversion

Treatment is generally based around conversation and people with a low score on this trait generally do not prefer this. Furthermore, people with a low score on this trait appear to dread the therapy and share less information, whereas the opposite appears true for people with high scores on this trait.

It is likely that extraversion is related to well-being. Extraversion is positively correlated with outcome. However, extraversion does not need to be increased but people with a certain score on this trait need to develop appropriate skills to deal with the situations they are dealing using their level of extraversion.

Openness

People low on this trait are not eager to experience themselves in new and unusual ways. They expect therapy to be a reassuring, practical experience. The therapies that are tolerated depend on the level of this trait.

There is a small correlation between scores in this trait and outcome. There is clinical prejudice in favour of people high in this trait and this might affect outcome ratings.

Agreeableness

People who score low on this trait are likely to be sceptical about the therapist. People who score high on this trait are likely to uncritically accept interventions of the therapist although this might be maladaptive too.

This trait does not predict outcome. People low on this trait are more likely to initiate early and unsatisfactory treatment termination.

Conscientiousness

People who score low on this trait are less likely to put effort in to alleviate the symptoms but have an equal desire to alleviate the symptoms. People who score high on this trait are willing and able to cooperate with treatment if the treatment is suitable for them.

This trait is correlated with treatment outcome. The effort of the client may be an important predictor for treatment outcome and effort is reflected in the trait score.