Crits-Christoph P, Siqueland L, Chittams J, Barber J P, Beck A T, Frank A, Liese B, Luborsky L, Mark D, Mercer D, Onken L S, Najavits L M, Thase M E, Woody G
Department of Psychiatry, University of Pennsylvania, USA.
J Consult Clin Psychol. 1998 Jun;66(3):484-92. doi: 10.1037//0022-006x.66.3.484.
This study assessed the effects of training on the performance of 65 therapists in delivering manual-guided therapies to 202 cocaine-dependent patients. Changes in ratings of therapists' adherence and competence was assessed in 3 treatment modalities: supportive-expressive dynamic therapy (SE), cognitive therapy (CT), and individual drug counseling. Effects of manual-guided training on the therapeutic alliance were also assessed. Training effects were examined through a hierarchical linear modeling approach that examined changes both within cases and across training cases. A large effect across cases was detected for training in CT. Supportive-expressive therapists and individual drug counselors demonstrated statistically significant learning trends over sessions but not over training cases. Training in SE and CT did not have a negative impact on the therapeutic alliance, although alliance scores for trainees in drug counseling initially decreased but then rebounded to initial levels.
本研究评估了培训对65名治疗师为202名可卡因依赖患者提供手动引导治疗的表现的影响。在三种治疗方式中评估了治疗师依从性和能力评分的变化：支持性-表达性动力疗法（SE）、认知疗法（CT）和个体药物咨询。还评估了手动引导培训对治疗联盟的影响。通过分层线性建模方法检查培训效果，该方法检查了病例内和培训病例间的变化。在CT培训中发现了跨病例的显著效果。支持性-表达性治疗师和个体药物咨询师在各疗程中表现出统计学上显著的学习趋势，但在培训病例中未表现出。SE和CT培训对治疗联盟没有负面影响，尽管药物咨询学员的联盟评分最初下降，但随后反弹至初始水平。
