Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy.
Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy.
Clin Psychol Psychother. 2018 Jan;25(1):85-101. doi: 10.1002/cpp.2131. Epub 2017 Sep 5.
Despite growing attention to the general therapist effects in a wide range of clinical settings, little is known about the individual, cross-situational, and therapy-nonspecific variables that impact on the differential effectiveness of clinicians. The current study is a systematic review of the evidence relating to the influence of therapist's subjective characteristics on outcomes of psychodynamic psychotherapies.
A multistage and systematic search of articles published between 1987 and 2017 identified 30 relevant studies, which were organized into 6 areas according to the specific therapist's variable considered.
Therapists' interpersonal functioning and skills showed the strongest evidence of a direct effect on treatment outcomes. Furthermore, there were preliminary evidence that therapists' attachment styles, their interpersonal history with caregivers, and their self-concept might affect outcomes through interaction effects with other constructs, such as technical interventions, patient's pathology, and therapeutic alliance. The high variability between studies on therapists' overall reflective or introspective abilities and personality characteristics suggested the need for more systematic research in these areas, whereas therapists' values and attitudes showed small effects on therapeutic outcome.
The present review clarifies how a deep examination of the contribution of therapists' subjective characteristics can help elucidate the complex association between relational and technical factors related to the outcome of psychodynamic treatments.
尽管越来越多的人关注广泛的临床环境中的一般治疗师效应，但对于影响临床医生差异疗效的个体、跨情境和非特定于治疗的变量知之甚少。本研究是对与治疗师主观特征对心理动力学心理治疗结果影响相关证据的系统回顾。
对 1987 年至 2017 年间发表的文章进行多阶段和系统搜索，确定了 30 项相关研究，根据所考虑的特定治疗师变量将这些研究分为 6 个领域。
治疗师的人际功能和技能显示出对治疗结果有直接影响的最强证据。此外，有初步证据表明，治疗师的依恋风格、他们与照顾者的人际历史以及他们的自我概念可能通过与其他结构（如技术干预、患者的病理学和治疗联盟）的相互作用影响结果。研究中治疗师整体反思或内省能力和个性特征的高度变异性表明需要在这些领域进行更系统的研究，而治疗师的价值观和态度对治疗结果的影响较小。
本综述阐明了深入检查治疗师主观特征的贡献如何有助于阐明与心理动力学治疗结果相关的关系因素和技术因素之间的复杂关联。
