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It's Good to Be a YAVIS

by Alice Shirrell Kaswell, with Lucille Zimmerman and G. Neil Martin

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.[1]

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 are:
* Young, Attractive, Verbal, Intelligent, and Successful
* Young, Attractive, Verbal, Insightful, and Successful
* Young, Attractive, Vital, Intelligent, and Successful
* 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.

Whence YAVIS?



The earliest use of YAVIS was, so far as we could tell, in the 1964 book "Psychotherapy: 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, pp. 135-44.

Jennings and Davis discovered that non-YAVISes simply have trouble meeting the standards required of good therapeutic patients. Here is how they describe their research:
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.

Partial YAVIS


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.

Valuable Research


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.

References


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>

_____________________

This article is republished with permission from the March-April 2001 issue of the Annals of Improbable Research. You can download or purchase back issues of the magazine, or subscribe to receive future issues. Or get a subscription for someone as a gift!

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