The Caine-Marteau-Dympna (CMD) Test, a new thematic apperception projective test, has acceptable inter-rater reliability. Validity was demonstrated by its ability to differentiate psychiatric in-patients from out-patients and non-patients, and by the relationships found between ratings derived from the test protocols and various questionnaires. These latter provide measures associated with either an inner or outer orientation towards the world. This has implications for many different areas of life, including occupational preference and adjustment, psychiatric symptom formation, psychological treatment expectancies and therapeutic outcome. Thus, the inner oriented individual, who is likely to be responsive to interpretative psychotherapy, tends to produce CMD responses displaying individualistic, abstract themes; a concern with intrapsychic conflict, deficiencies in social interaction and lack of structure; and internal control.