Whalley Ben, Hyland Michael E
University of Plymouth, Plymouth, UK.
Psychol Psychother. 2009 Sep;82(Pt 3):291-303. doi: 10.1348/147608309X413275. Epub 2009 Mar 14.
A common sense view in psychotherapy holds that there are individual differences in response to different treatments. However, despite considerable effort, no clear rationale exists to guide the selection of therapy for individual patients.
Rather than focusing on specific components of therapy as a basis to predict interactions between patients and treatments, we draw on motivational concordance theory and a contextual model of psychotherapy to test whether, in an analogue study, perceived effectiveness of different therapy vignettes is related to human values.
Two samples (undergraduates and members of the public) read short vignettes, informed by six therapies for depression (cognitive behaviour therapy, client-centred therapy, antidepressant medication, existential psychotherapy, psychodynamic psychotherapy, and a complementary medicine: Bach flower essences), provided ratings of perceived effectiveness, and completed questionnaire measures of dispositional motivations (Schwartz Values Scale and the Spiritual Connection Questionnaire-14). Responses were analysed using multidimensional scaling (MDS).
In both samples, expectancy for the cognitive behavioural-informed vignette was related to Self-direction and Stimulation, and was opposed to Tradition, Conformity and Security. Expectancies for the Drug vignette were associated with Power and Security.
People perceive therapies as more effective if the therapy is congruent with their values. These preliminary data suggest motivational concordance is a useful framework for predicting client-treatment interactions.
心理治疗中的一种常识性观点认为，对不同治疗方法的反应存在个体差异。然而，尽管付出了巨大努力，但目前尚无明确的理论依据来指导为个体患者选择治疗方法。
我们并非将重点放在治疗的特定组成部分上，以此作为预测患者与治疗方法之间相互作用的基础，而是借鉴动机一致性理论和心理治疗的情境模型，来检验在一项模拟研究中，不同治疗案例的感知有效性是否与人类价值观相关。
两个样本（大学生和公众）阅读了简短的案例，这些案例基于六种治疗抑郁症的方法（认知行为疗法、以人为中心疗法、抗抑郁药物、存在主义心理治疗、精神动力心理治疗以及一种补充医学：巴赫花精），对感知有效性进行评分，并完成了关于性格动机的问卷调查（施瓦茨价值观量表和精神联系问卷 - 14）。使用多维尺度分析（MDS）对回答进行分析。
在两个样本中，对基于认知行为疗法的案例的期望与自我导向和刺激相关，且与传统、遵从和安全相反。对药物案例的期望与权力和安全相关。
如果治疗方法与个人价值观相符，人们会认为其更有效。这些初步数据表明，动机一致性是预测患者 - 治疗相互作用的一个有用框架。
