National Institute for Health and Welfare, Helsinki, Finland.
J Affect Disord. 2012 May;138(3):301-12. doi: 10.1016/j.jad.2012.01.023. Epub 2012 Feb 14.
Short- and long-term psychotherapies have been found effective for treating mood and anxiety disorders. Although psychotherapists differ in their effectiveness, virtually no comparative research exists on the therapist characteristics beneficial to short- or long-term therapy.
Altogether 326 outpatients, aged 20-46 years, and suffering from mood or anxiety disorder, were randomly assigned to either short-term (solution-focused or psychodynamic therapy, combined) or long-term (psychodynamic) psychotherapy, and were followed up for 3 years. Therapies were provided by 55 volunteering therapists with at least 2 years of work experience in the given form of therapy. Therapists' professional and personal characteristics, measured before randomization, were assessed with the Development of Psychotherapists Common Core Questionnaire (DPCCQ). Patients' general psychiatric symptoms were assessed as the main outcome measure at baseline and 3, 7, 9, 12, 18, 24 and 36 months after start of treatment with the Symptom Check List, Global Severity Index (SCL-90-GSI).
Active, engaging, and extroverted therapists produced a faster symptom reduction in short-term therapy than in long-term therapy. More cautious, non-intrusive therapists generated greater benefits in long-term therapy during the 3-year follow-up. Therapists' lower confidence and enjoyment in therapeutic work predicted poorer outcomes in short-term therapy in the long run.
Generalizability may be limited due to relatively experienced therapists.
Therapist characteristics apparently are important determinants of effectiveness of short- and long-term psychotherapy. If confirmed in future studies, results may be applied in training and supervision of therapists as well as in fitting therapy forms with therapist dispositions to maximize treatment benefits.
短期和长期心理疗法已被证明对治疗情绪和焦虑障碍有效。尽管心理治疗师在疗效上存在差异，但实际上几乎没有关于对短期或长期治疗有益的治疗师特征的比较研究。
共有 326 名年龄在 20-46 岁之间的门诊患者，患有情绪或焦虑障碍，被随机分配到短期（以解决问题为重点或心理动力学治疗，联合）或长期（心理动力学）心理治疗组，并随访 3 年。治疗由 55 名有至少 2 年治疗经验的志愿者治疗师提供。治疗师的专业和个人特征在随机分组前通过发展心理治疗师通用核心问卷（DPCCQ）进行评估。患者的一般精神症状作为主要结局指标，在基线和治疗开始后 3、7、9、12、18、24 和 36 个月使用症状检查表、总体严重度指数（SCL-90-GSI）进行评估。
积极、投入和外向的治疗师在短期治疗中比长期治疗中更快地减轻症状。更谨慎、非侵入性的治疗师在 3 年随访期间在长期治疗中产生了更大的益处。治疗师对治疗工作的信心和享受程度较低，预示着短期治疗的长期预后较差。
由于治疗师相对有经验，推广性可能有限。
治疗师特征显然是短期和长期心理治疗效果的重要决定因素。如果在未来的研究中得到证实，结果可以应用于治疗师的培训和监督，以及将治疗形式与治疗师的性格相匹配，以最大限度地提高治疗效果。
