Henry W P, Schacht T E, Strupp H H, Butler S F, Binder J L
Department of Psychology, Vanderbilt University, Nashville, Tennessee 37240.
J Consult Clin Psychol. 1993 Jun;61(3):441-7. doi: 10.1037//0022-006x.61.3.441.
Sixteen therapists were enrolled in a year-long manualized training program as part of the Vanderbilt II study of time-limited dynamic psychotherapy (TLDP). The training program successfully changed therapists' interventions in line with prescriptions of the TLDP manual, but some unanticipated changes ran counter to the intent of the training, including increased negative interpersonal transactions as indicated by process measures such as the Structural Analysis of Social Behavior (SASB). We examined therapist variables, patient variables, and training variables that appeared to mediate therapist responses to the training program. Results indicate that patient difficulty may mediate certain aspects of therapists' responses to training. Therapists with self-reported hostile and controlling introjects showed the greatest technical adherence, which was intriguing because prior research has linked hostile therapist introject to greater frequency of counter-therapeutic interpersonal process. Of special interest were differences in effects of training associated with individual training faculty. This finding, if generalizable, has important implications for manualized therapy research, especially multisite trials.
作为范德比尔特限时动力心理治疗（TLDP）二期研究的一部分，16名治疗师参加了为期一年的手册化培训项目。该培训项目成功地使治疗师的干预措施符合TLDP手册的规定，但一些意外变化与培训意图背道而驰，包括社会行为结构分析（SASB）等过程指标显示的负面人际互动增加。我们研究了似乎能调节治疗师对培训项目反应的治疗师变量、患者变量和培训变量。结果表明，患者的困难程度可能调节治疗师对培训反应的某些方面。自我报告有敌对和控制内射的治疗师表现出最高的技术依从性，这很有趣，因为先前的研究已将敌对的治疗师内射与更多的反治疗人际过程联系起来。特别令人感兴趣的是与个别培训教员相关的培训效果差异。这一发现如果具有普遍性，对手册化治疗研究，尤其是多地点试验具有重要意义。
