This study compares USA and New Zealand psychiatric patients' requests at the initial psychiatric interview and examines clinician's accuracy in estimating patients' treatment request preferences. Eighty-five of the 146 consecutive nonacute patients to the psychiatric unit of a public New Zealand hospital completed a 14-item Patient Request Form before their initial interview and their clinician completed an equivalent form at the end of the interview. Patients' treatment request preferences were similar in the USA and New Zealand samples as were clinician's tendency to underestimate the importance their patients placed on requests. The results are discussed in relation to effective treatment planning. © 1987, Sage Publications. All rights reserved.