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适度而渐进:有效的治疗师往往对治疗变化的评价不如他们的患者积极。

Modest, yet progressive: Effective therapists tend to rate therapeutic change less positively than their patients.

机构信息

Institute for Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Saxonia, Germany.

出版信息

Psychother Res. 2020 Apr;30(4):433-446. doi: 10.1080/10503307.2019.1631502. Epub 2019 Jun 21.

Abstract

Empirical findings on self-serving biases amongst psychotherapists are inconsistent. We tested in a large naturalistic data set, if therapists are prone to illusory superiority when estimating their patients' outcome and whether this effect is buffered by therapists' effectiveness. A post-hoc analysis with  = 69 therapists, who treated  = 1080 patients, was conducted. Therapists' and patients' mean ratings for therapeutic improvement in the Clinical Global Impression Scale (CGI) were compared. Using a multilevel modelling approach, we further investigated the relation between the patient-therapist divergence in the CGI and actual therapeutic change in the Global Severity Index (GSI) of the Brief Symptom Inventory and in the Satisfaction With Life Scale (SWLS). Ratings in the CGI did not show significant differences between patients' and therapists' assessment of therapeutic change. Lower estimations by therapists, compared to patients' self-report, were associated with greater therapeutic change in GSI and SWLS. Therapists, on a whole, did not seem to be prone to illusory superiority when assessing therapeutic outcome. Contrary, the more modest the therapists' estimation of therapeutic outcome was, the greater the actual therapeutic change.

摘要

关于治疗师自利偏差的实证研究结果并不一致。我们在一个大型自然主义数据集里进行了测试,以检验治疗师在估计患者治疗效果时是否容易产生虚幻的优越感,以及这种效应是否会被治疗师的有效性所缓冲。对 69 名治疗师(治疗了 1080 名患者)进行了事后分析。比较了治疗师和患者在临床总体印象量表(CGI)中对治疗改善的平均评分。使用多层建模方法,我们进一步研究了 CGI 中患者与治疗师之间的差异与Brief Symptom Inventory 的全球严重程度指数(GSI)和生活满意度量表(SWLS)中的实际治疗变化之间的关系。CGI 的评分在患者和治疗师对治疗变化的评估之间没有显示出显著差异。与患者的自我报告相比,治疗师的评估较低,与 GSI 和 SWLS 的治疗变化更大相关。总的来说,治疗师在评估治疗效果时似乎并没有倾向于虚幻的优越感。相反,治疗师对治疗效果的估计越保守,实际的治疗变化就越大。

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