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Dudek takes a very sophisticated approach to changes resulting from therapy. His study does not deal with matched groups; it is concerned with the direction of internal change following therapeutic intervention. This is contrasted with behavioral changes and the varying degrees of success of different forms of therapy. His measurement tool is the Rorschach, utilizing pretherapy records and records obtained at varying intervals up to eighteen years. The patients undergoing analytically oriented psychotherapy showed changes in the direction of a liberation of psychic energy, more awareness, and better reality adjustment. Patients receiving medical treatment, such as electric convulsive therapy and drugs, changed in the direction of better reality contact and social functioning, but this was accompanied by personality constriction. The third group, undergoing a regimen of maintenance and supportive measures, showed the least change and when it occurred, it was also accompanied by personality constriction. The author is quite explicit in evaluating his data and maintains that no mode of therapy necessarily produces more successes or is intrinsically indicated for a particular type of disturbance.