Department of Psychology, York University, Toronto, Canada.
Psychotherapy (Chic). 2011 Sep;48(3):283-92. doi: 10.1037/a0022011.
Little is known about factors differentiating more and less effective therapists or the mechanisms through which therapists influence outcome. In the present study, the performance of a small sample of 4 therapists was compared in the context of delivering cognitive-behavioral psychotherapy (CBT) to 32 clients with generalized anxiety disorder. More effective therapists were characterized by higher observer-rated CBT competence, higher client outcome expectations and client treatment credibility assessments, and higher early treatment client ratings of therapeutic alliance quality. Higher early CBT competence was associated with higher client midtreatment outcome expectations, which in turn were associated with better posttreatment outcomes. Although these findings are preliminary given the small sample of therapists and clients, they suggest that the common factor of outcome expectations might be a mechanism through which the specific factor of psychotherapist competence exerts its influence on treatment outcome. The implications of these findings and directions for future research are discussed.
关于区分更有效和不太有效的治疗师的因素，以及治疗师通过何种机制影响治疗结果，目前知之甚少。在本研究中，在对 32 名广泛性焦虑障碍患者进行认知行为心理治疗（CBT）的背景下，比较了 4 名小样本治疗师的表现。更有效的治疗师具有更高的观察者评定的 CBT 能力、更高的患者治疗预期和患者治疗可信度评估，以及更高的早期治疗患者对治疗联盟质量的评价。较高的早期 CBT 能力与较高的患者中期治疗预期相关，而较高的中期治疗预期又与更好的治疗后结果相关。鉴于治疗师和患者的样本量较小，这些发现尚属初步结果，但它们表明，治疗结果的共同因素（即治疗预期）可能是治疗师能力这一特定因素对治疗结果产生影响的机制。讨论了这些发现的意义和未来研究的方向。
