Branson Amanda, Shafran Roz, Myles Pamela
School of Psychology and CLS, University of Reading, Earley Gate, Reading, Berkshire RG14 6AL, United Kingdom.
Child Health Centre, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
Behav Res Ther. 2015 May;68:19-26. doi: 10.1016/j.brat.2015.03.002. Epub 2015 Mar 7.
Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government's Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed.
对于治疗师的能力与常见心理健康障碍患者治疗结果之间的关系，人们了解甚少。理解能力与患者治疗结果之间的关系对于认知行为疗法（CBT）的传播和实施至关重要。当前的研究通过在英国政府改善心理治疗可及性（IAPT）计划的框架内，探索常规临床实践中CBT能力与患者治疗结果之间的关系，扩展了现有文献。参与者包括43名治疗师，他们在一年的培训期内治疗了1247名患者。结果发现，几乎没有证据支持CBT能力与患者治疗结果之间存在普遍关联；然而，能力最强的治疗师的患者中，症状有可靠改善的人数显著多于仅靠随机因素预期的人数，且经历无可靠变化的人数更少。相反，能力最差的治疗师治疗的患者中，症状出现可靠恶化的人数显著多于预期。本文讨论了这些结果对CBT传播和实施的影响。
