It's Good to Be a YAVIS
YAVIS is a term psychotherapists
use to describe the profession's favored type of patient. YAVISes are the
patients who most benefit, in the eyes of therapists, from seeing the therapists.
Here is a quick primer on the subject.
The letters in YAVIS stand for "Young, Attractive Verbal, Intelligent, and Successful." This charming acronym is little known to the public. Within the professional psychotherapeutic community, it is discussed guardedly. Initially it was used as something of a wry criticism:
In 1966 it was already a cliche that the patients who did best in psychotherapy were those who did not need it. The YAVIS criterion was an inside joke. Young, attractive, vital, intelligent, successful individuals benefit best from psychotherapy. In other words, the patients we work best with are the ones who need us least.
Later, though, many came to take it as less of a criticism, and more of
a common sense guideline for professional success.
Psychotherapy is a difficult undertaking, in which success is hard to define,
and nearly impossible to predict. Even now, the most reliable predictor
of psychotherapeutic outcome -- some say the ONLY reliable predictor --
is whether or not the patient is a YAVIS.
The Varieties of YAVIS
The components of the phrase YAVIS are slightly fungible. Some common variants
Ý Young, Attractive, Verbal, Intelligent, and Successful
Ý Young, Attractive, Verbal, Insightful, and Successful
Ý Young, Attractive, Vital, Intelligent, and Successful
Ý Young, Affluent, Verbal, Insured, and Single (or, in "German: Jung, Wohlhabend, Sprachgewandt, Versichert, und Alleinstehend")
There is, by the way, an opposite for the term YAVIS. It is HOUND, the
explanation of which is perhaps best given on page 202 of Winfried Huber's
classic work, "Les Psychothérapies: Quelle Thérapie Pour
Quel Patient?" (1993, Paris, Nathan). The flavor is most piquant in
the original French:
HOUND (c'est à dire casanier, vieux, sans succès, verbalement et intellectuellement peu doué) vous donnerait moins de chance d'être accepté par un psychanalyste et même tout simplement d'être pris en psychothérapie.
The earliest use of YAVIS was, so far as we could tell, in the 1964 book
the Purchase of Friendship," by William Schofield (Prentice Hall,
Englewood Cliffs, New Jersey). A professor of psychiatry at the University
of Minnesota Medical School, Schofield was not admiring of therapists'
apparent preference for some patients over others. On page 133 of his book,
the word makes its print debut:
What is there in the general theory of psychodynamics or psychotherapy to suggest that the neurosis of a 50-year-old commercial fisherman with an eighth-grade education will be more resistant to psychological help than a symptomatically comparable disturbance in a 35-year-old, college-trained artist?...
It seems... likely that there are pressures toward a systematic selection of patients, pressures that are perhaps subtle and unconscious in part and that, in part, reflect theoretical biases common to all psychotherapists. These selective forces tend to restrict the efforts of the bulk of social workers, psychologists, and psychiatrists to clients who present the "Yavis" syndrome -- clients who are youthful, attractive, verbal, intelligent, and successful.
Keeping Up With the YAVISes
Not everyone in the therapeutic community agrees with this dour viewpoint.
Some researchers took steps, however tentative, to inquire how non-YAVISES
might be taught to behave in ways that would make them more attractive to
therapists. A sterling example is given in the research report "Attraction-Enhancing
Client Behaviors: a Structured Learning Approach for 'Non-Yavis, Jr.,'"
Rick L. Jennings and Carl S. Davis, Journal
of Consulting and Clinical Psychology, vol. 45, no. 1, February 1977,
Jennings and Davis discovered that non-YAVISes simply have trouble meeting
the standards required of good therapeutic patients. Here is how they describe
The purpose of [our] study was to determine the effects of using structured learning techniques to train lower socioeconomic emotionally disturbed children and adolescents in verbal behaviors that are (a) useful in interviews, (b) attraction enhancing, and that (c) generalize to the psychotherapeutic context....
What Jennings and Davis found is discouraging:
The effect of the experimental treatment upon attraction in the psychotherapeutic context was nonsignificant.
But Jennings and Davis were not stymied by this discouraging news.
Teaming up with two additional colleagues, Jennings and Davis then tried
to narrow the range of the problem.
This resulted in the report "Attractive Versus Unattractive Clients:
Mediating Influences on Counselor's Perceptions," Kathleen N. Lewis,
Carl S. Davis, Brian J. Walker, and Rick L. Jennings, Journal
of Counseling Psychology, vol. 28, no. 4, July 1981, pp. 309-14.
Lewis, Davis, Walker, and Jennings imply that all is not lost if you're
not a complete, total YAVIS:
...Thus, although counselors tend to favor young, attractive, verbal, intelligent and successful (YAVIS) C[lient]s, certain YAVIS characteristics may have a more potent effect on C[lient] attractiveness than others.
This is happy news. To be a good, attractive patient, it's possible that
you need just some -- not necessarily all -- of the YAVIS qualities.
On the matter of YAVISes, much is still unknown.
There are people whose family name is Yavis. It would be interesting and
perhaps instructive to find out their experience with psychotherapy -- average
duration and outcome, satisfaction of the Yavises (be they also YAVISes
or not) and of their therapists. Here's another question: Are Yavises actively
solicited by the therapeutic community? Fascinating and perhaps important
as it might be to know these things, we hesitate to do this research ourselves.
We leave it for others, who are more young, more attractive more verbal,
more intelligent, and more successful than we, to pursue the Yavises for
all they're worth.
1. George vonHilsheimer, PH.D., in his book "Brief Therapy: Doing Therapy Quickly and Effectively," available on the web site <http://www.eegspectrum.com/books/gvh/brief01.htm>
© Copyright 2001 Annals of Improbable Research (AIR)