Aim: Decades of psychotherapy research suggest that patient-therapist match accounts for outcome beyond single patient or therapist variables. The therapist’s personality does influence the psychotherapeutic process. This study examines how the therapist’s personality configuration (orientation on relatedness and on self-definition) manifests itself early in the relationship to the patient. Furthermore, we examine the associations between different patterns of patient-therapist matching (convergent or complementary personality configurations) and outcomes at termination of psychotherapy with young adults. Method: Thirty-three patients and their therapists were interviewed at baseline. Prototype Matching of Anaclitic-Introjective Personality Configuration (PMAI) was applied to the interview material by two pairs of independent judges. Patients and their therapists were classified as predominately anaclitic or introjective at baseline (16 convergent and 17 complementary dyads). Outcome measures included Symptom Checklist-90-R and Differentiation-Relatedness scale at baseline and at termination. Results: Patients in the convergent patient-therapist dyads (both anaclitic or both introjective) showed significantly greater symptom reduction and increased developmental levels of representations of mother than patients in the complementary dyads (opposite personality configurations). Convergent patient-therapist match was connected with larger effect sizes on all outcome measures and lower proportion of non-improved patients. Different personality configurations could be actualized in the same therapist.Discussion: These findings suggest the importance of the therapists’ early adjusting their orientation on relatedness or on self-definition to their patients’ predominant personality configuration in order to enhance treatment outcome. Further and larger studies are needed to draw more far-reaching conclusions about the relations between patient-therapist personality match and the treatment efficacy.