Clements-Hickman Alyssa L, Reese Robert J
Department of Psychological Sciences, Auburn University, Auburn, AL, USA.
Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA.
Psychother Res. 2023 Feb;33(2):173-184. doi: 10.1080/10503307.2022.2080610. Epub 2022 May 28.
Studies examining the unique contribution that the therapist has on outcomes (i.e., "therapist effects") have increased in recent years. Therapist effects are believed to occur via how the therapist's interpersonal and intrapersonal qualities influence the therapeutic relationship, which in turn influences outcomes. The current study focused on the extent to which professional self-doubt, counseling self-efficacy, and humility are therapist qualities that influence treatment outcomes. Data were collected from 46 therapists at a multi-site community behavioral health organization. Therapists completed measures of therapist characteristics. Therapists' responses were matched with de-identified archival client data (= 1, 817) that contained an outcome and alliance measure administered every session. Multilevel modeling was used to determine the extent to which therapists' personal characteristics predicted client outcomes. Results of the unconditional model for the alliance measure indicated a lack of growth in alliance scores across treatment. Approximately 5% of the variance in rate of growth for treatment outcome was between therapists. When controlling for the effects of counseling self-efficacy, professional self-doubt was marginally significant. When counseling-self-efficacy was removed from the model, professional self-doubt was no longer marginally significant. The findings highlight the complexity of therapist effects and the need for future research on this topic.
近年来，研究治疗师对治疗结果的独特贡献（即“治疗师效应”）的研究有所增加。人们认为，治疗师效应是通过治疗师的人际和个人品质如何影响治疗关系而产生的，而治疗关系又会反过来影响治疗结果。当前的研究聚焦于职业自我怀疑、咨询自我效能感和谦逊这些治疗师品质在多大程度上会影响治疗结果。数据收集自一家多地点社区行为健康组织的46名治疗师。治疗师完成了治疗师特征的测量。治疗师的回答与经过去识别处理的档案客户数据（=1817）相匹配，这些数据包含每次治疗时进行的结果和联盟测量。使用多层模型来确定治疗师的个人特征在多大程度上能够预测客户的治疗结果。联盟测量的无条件模型结果表明，整个治疗过程中联盟分数没有增长。治疗结果增长率的差异中约有5%存在于治疗师之间。在控制咨询自我效能感的影响后，职业自我怀疑具有边缘显著性。当从模型中去除咨询自我效能感时，职业自我怀疑不再具有边缘显著性。研究结果凸显了治疗师效应的复杂性以及未来对该主题进行研究的必要性。
