Do therapists subjective variables impact on psychodynamic psychotherapy outcomes? A systematic literature review (original) (raw)
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2018
Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy Correspondence Prof. Vittorio Lingiardi, Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy. Email: vittorio.lingiardi@uniroma1.it
The professional and personal characteristics of effective psychotherapists: a systematic review
Psychotherapy Research, 2019
Objective: Psychotherapists differ notably in the outcomes their patients achieve, and the characteristics that may explain these differences have attracted increasing interest. We systematically review studies on therapist pre-treatment characteristics predicting patient outcomes. Method: Systematic searches on databases for psychotherapy research, clinical psychology, and medical science for the years 2000-2018 identified published research examining therapist characteristics and psychotherapy outcomes. Of 2041 studies, 31 met inclusion criteria. Results: Findings show a few direct effects of therapist intrapersonal variables (e.g., self-relatedness, attachment) and several interaction effects with other constructs (e.g., patient pathology) on outcome. There is little support for the relevance of self-rated social skills. However, more consistent evidence has recently emerged for performance-based measurements of professional interpersonal skills, especially when elicited in challenging situations. Patient outcomes were also predicted by therapists' self-rated professional characteristics, such as their experienced difficulties in practice, coping mechanisms, and attitudes towards therapeutic work, indicating that therapist self-perception also matters, although not always in the direction expected. Conclusions: More effective therapists seem characterized by professionally cultivated interpersonal capacities, which are likely rooted in their personal lives and attachment history. Research guidelines are proposed for moving this field forward (including larger samples, multilevel modeling, and in-depth qualitative work).
Journal of affective disorders, 2012
BACKGROUND: Short- and long-term psychotherapies have been found effective for treating mood and anxiety disorders. Although psychotherapists differ in their effectiveness, virtually no comparative research exists on the therapist characteristics beneficial to short- or long-term therapy. METHODS: Altogether 326 outpatients, aged 20-46years, and suffering from mood or anxiety disorder, were randomly assigned to either short-term (solution-focused or psychodynamic therapy, combined) or long-term (psychodynamic) psychotherapy, and were followed up for 3years. Therapies were provided by 55 volunteering therapists with at least 2years of work experience in the given form of therapy. Therapists' professional and personal characteristics, measured before randomization, were assessed with the Development of Psychotherapists Common Core Questionnaire (DPCCQ). Patients' general psychiatric symptoms were assessed as the main outcome measure at baseline and 3, 7, 9, 12, 18, 24 and 36...
Over the past two decades, research has turned its attention from studies of therapist and patient traits to studies of manualired therapy models and technical procedures. Randomized clinical trials desms, while making many contributions to understanding psycho- therapy and even increasing the available evidence of its dcacy, have not adequately addressed the unique contributions of patient and therapist characteristics. Indeed, in some ways, the adoption of randomized clin- ical trials as the ”gold standard” of research methodol- ogy may have inadvertently obscured the roles of ther- apist and patient vuiables in eUective psychotherapy. This article uses therapist experience and training as examples of Variables whose contributions cannot be assessed by using diagnosis as a standard of patient uniformity or manual adherence as a standard of therapy.
Journal of Clinical Psychology, 2006
This study examined data collected on over 5,000 clients seen by 71 therapists over a 6-year period in a University Counseling Center. Clients were given the Outcome Questionnaire-45 (OQ-45) on a session-bysession basis to track their treatment response. Data were also collected on therapists' theoretical orientation, years of experience, gender, and type of training. Data were analyzed using hierarchical linear modeling (HLM) to see if general therapist traits (i.e., theoretical orientation, type of training) accounted for differences in clients' rate of improvement. Data were then analyzed, again using HLM with therapists as a fixed effect, to compare individual therapists to see if there were significant differences in the efficiency of treatment. In addition, pre-minus posttest OQ-45 scores were examined to see if there were differences in the overall outcome of clients. There was a significant amount of variation among therapists' clients' rates of improvement. Therapist feedback reports were generated to summarize client outcome for individual providers in contrast to center averages and in an attempt to improve client outcome.
THE THERAPIST'S THERAPIST: A REPLICATION AND EXTENSION 20 YEARS LATER
How do mental health professionals choose their own psychotherapists? This study replicates and extends a 1987 national survey of psychotherapists regarding the selection criteria and sociodemographic characteristics of their personal therapists; 608 psychologists, counselors, and social workers participated. Therapists' therapists tended to be middle aged and White (94%) but equally female and male. Their most frequent theoretical orientations were integrative, eclectic, cognitive, and psychodynamic (but rarely behavioral or systemic). Psychology was their most prevalent profession, followed by social work, counseling, and psychiatry. Topping the list of therapist selection criteria were competence, warmth, experience, openness, and reputation. The prototypical positive features of personal treatment that therapists repeated with their own patients all concerned cultivation of the therapeutic relationship. The 2007 results are tentatively compared with those obtained in 1987, thus chronicling the evolution of therapists' therapists over the years.
Frontiers in Psychology, 2021
Background: The aim of this manuscript is to analyze the degrees of responsibility for healing that psychotherapists attribute to a set of emotional variables of the therapist involved in the therapeutic process. Such variables, framed within the well-known common factors in psychotherapy, have been proven to be essential in making the therapeutic process effective, as has been shown by research in psychotherapy in recent decades. Materials and Methods: Based on an extensive literature review, the responses from a sample of 69 psychotherapists to a tool created ad hoc are analyzed to verify whether their attributions are in line with the results of said review. Results: The therapists have doubts about the factors responsible for psychotherapeutic effectiveness, as well as about the value of common variables, including those of an emotional nature, not valuing them above those of a specific type. They also argue against the similar effectiveness of different psychotherapeutic models. Conclusion: Discrepancies have thus been found between the conclusions reached by research on therapeutic processes and the statements made by the therapists studied, which could indicate an insufficient impact of psychotherapeutic research on clinical practice. We also propose courses of action such as establishing training programs for the acquisition and development of emotional skills for therapists that could increase the effectiveness of their interventions.