One component of psychotherapy is the type of psychotherapeutic atmosphere created by the therapist. The various character structures of patients require different psychotherapeutic atmospheres. Three character structures are identifiable, each distinguished by a style of social cognition which parallels a stage of cognition in the child as described by Piaget. The social cognition of the symbolic adult who confuses identity and reality parallels the symbolic-stage of a child's cognition. An empathetic-immersion atmosphere in which the patient feels connected to the therapist and the therapist manages the connection is generally most effective with this type of patient. The intuitive adult who has a heteronomous superego and judges on the basis of appearance corresponds to the intuitive-stage child and tends to benefit from a parenting psychotherapeutic atmosphere. The operational adult who has an autonomous superego and judges on the basis of abiding values parallels the concrete operational-stage child. This type of patient is most likely to benefit from an almost pure scientific laboratory atmosphere which relies on transference interpretation as its major tool. This Piagetian-based model of character structure can help therapists to distinguish different types of patients and to understand the experiences and effects of different psychotherapy approaches. (NRB)