Department of Clinical Psychology and Psychotherapy.
J Consult Clin Psychol. 2022 Jun;90(6):478-490. doi: 10.1037/ccp0000738. Epub 2022 May 23.
The therapist effect has been demonstrated in various studies. However, studies on putative therapist characteristics show heterogeneous results. Although the majority of studies have solely examined effects between therapists, a growing interest in effects within therapists has emerged. However, it remains unclear whether therapist characteristics are rather a state-like than a trait-like phenomenon. The main aim of the present study is to test whether clinical microskills as well as correct application of techniques and strategies (both between and within therapists) predict across-session change of symptom severity in a large naturalistic data set.
The results are based on 398 patients and 48 therapists who treated 5-17 patients each. Clinical microskills and correct application of techniques/strategies were rated using the Inventory of Therapeutic Interventions and Skills, and symptom severity was assessed with the Hopkins Symptom Checklist-11.
Results demonstrated significant within- and between-therapist variability in clinical microskills and correct application of techniques/strategies, and no change over the course of treatment in both variables. Moreover, correct application of techniques/strategies was significantly associated with symptom improvement within, but not between therapists. In addition, higher treatment difficulty as well as an interaction between treatment difficulty and correct application of techniques/strategies were significantly associated with symptom improvement. Clinical microskills were neither predictive of symptom improvement within nor between therapists.
These results provide initial evidence that not the therapist's average correct application of techniques/strategies is important, but rather how correctly they use a technique with a specific patient. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
治疗师效应已在多项研究中得到证实。然而，关于假定治疗师特征的研究结果存在差异。尽管大多数研究仅考察了治疗师之间的效果，但人们对治疗师内部效果的兴趣日益增加。然而，治疗师的特征是一种状态现象还是一种特质现象仍不清楚。本研究的主要目的是检验临床微观技能以及技术和策略的正确应用（无论是在治疗师之间还是内部）是否可以预测在一个大型自然数据集中症状严重程度的跨疗程变化。
结果基于 398 名患者和 48 名治疗师，每位治疗师治疗 5-17 名患者。使用治疗干预和技能清单评估临床微观技能和技术/策略的正确应用，使用霍普金斯症状清单-11 评估症状严重程度。
结果表明，临床微观技能和技术/策略的正确应用在治疗师内部和治疗师之间存在显著的变异性，并且这两个变量在治疗过程中都没有变化。此外，技术/策略的正确应用与治疗师内部的症状改善显著相关，但与治疗师之间的症状改善无关。此外，较高的治疗难度以及治疗难度与技术/策略正确应用之间的相互作用与症状改善显著相关。临床微观技能既不能预测治疗师内部也不能预测治疗师之间的症状改善。
这些结果初步表明，重要的不是治疗师平均正确应用技术/策略，而是他们如何正确地将技术应用于特定患者。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
