AbstractThe fit of patient coping style and psychotherapy focus has been suggested as improving treatment outcome. This article reviews the definitions, measures, and previous research surrounding this hypothesis. An original meta‐analysis of 12 carefully selected studies (N = 1,291 patients) resulted in a weighted, mean effect size (d) of .55 in favor of a fit between externalizing patients and symptom‐focused treatment or, alternatively, internalizing patients and insight‐focused treatment. This medium‐size effect indicates that nondiagnostic patient factors, like coping style, are important considerations in the selection of effective therapies. Clinical examples and clinical recommendations are provided. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 67:176–183, 2011.