Department of Psychology, The Pennsylvania State University, 115C Moore Building, University Park, PA 16802, USA.
J Consult Clin Psychol. 2010 Oct;78(5):717-23. doi: 10.1037/a0020088.
This study was an investigation of the relationships among therapist training variables, psychotherapy process, and session outcome in a psychotherapy training clinic. The aims were to assess the relationship between "training as usual" and intervention use in individual psychotherapy, to investigate the relationship between therapist intervention use and session outcome, and to test whether training variables moderate this relationship.
Graduate student therapists (n = 19; mean age = 27 years; 79% women; 84% White) provided information about their training and completed a measure of intervention use (Multitheoretical List of Therapeutic Interventions; McCarthy & Barber, 2009) and clients (n = 42; mean age = 33 years; 64% women; 95% White) completed a measure of session outcome (Session Progress Scale; Kolden, 1991) after each session of individual psychotherapy.
With regard to intervention use and session outcome, no main effects were found for the training variables. Consequently, tests of moderation were not performed. The final model for intervention use and session outcome yielded main effects for time-varying interpersonal therapy and time-varying common factor use, and a 3-way interaction among time-varying cognitive-behavioral (CBT) intervention use, between-patient common factor use, and between-therapist common factor use. Patients who received more common factor interventions on average rated sessions as less helpful when more CBT interventions were employed; this finding was stronger for patients who were being treated by therapists with higher average levels of common factor use.
Implications for training are discussed, with particular attention paid to the importance of clinical decision making and the complex interaction between common and unique technical factors in practice.
本研究旨在探讨心理治疗培训诊所中治疗师培训变量、心理治疗过程和治疗效果之间的关系。目的是评估个体心理治疗中“常规培训”与干预措施使用之间的关系，调查治疗师干预措施使用与治疗效果之间的关系，并检验培训变量是否调节这种关系。
研究生治疗师（n=19；平均年龄 27 岁；79%为女性；84%为白人）提供了有关培训的信息，并完成了干预措施使用量表（Multitheoretical List of Therapeutic Interventions；McCarthy & Barber, 2009）和客户（n=42；平均年龄 33 岁；64%为女性；95%为白人）在每次个体心理治疗后完成了治疗效果量表（Session Progress Scale；Kolden, 1991）。
在干预措施使用和治疗效果方面，培训变量没有显著的主效应。因此，没有进行调节作用的检验。干预措施使用和治疗效果的最终模型显示，时间变化的人际治疗和时间变化的共同因素使用有主效应，而认知行为（CBT）干预措施使用、患者间共同因素使用和治疗师间共同因素使用之间存在 3 -way 交互作用。当使用更多的 CBT 干预措施时，接受更多共同因素干预的患者平均认为治疗效果较差；对于接受平均共同因素使用水平较高的治疗师治疗的患者，这种发现更为强烈。
讨论了培训的意义，特别关注临床决策的重要性以及实践中常见和独特技术因素之间的复杂相互作用。
