Psychotherapists' self-reports of their interpersonal functioning and difficulties in practice as predictors of patient outcome
Psychotherapists' self-reports of their interpersonal functioning and difficulties in practice as predictors of patient outcome
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DOI：
10.1080/10503307.2012.735775
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发表时间：
2013-01-01
影响因子：
3.9
通讯作者：
Ronnestad, Michael Helge
中科院分区：
文献类型：
--
作者：
Nissen-Lie, Helene A.;Monsen, Jon Trygve;Ronnestad, Michael Helge
一些研究强调了心理治疗研究理解治疗师效应的必要性。在一项大型自然主义研究（255名患者，70名治疗师）中，这个主题是通过治疗师在实践中自我评估的困难和治疗工作中的人际功能作为三种常规结果测量中患者结果的预测因素来解决的。采用三水平增长曲线分析来评估心理治疗师共同核心问卷开发（Orlinsky & Ronnestad, 2005）测量的治疗师特征是否预测患者症状困扰（SCL-90R）、人际问题（IIP-64）和观察者评定的整体功能（GAF）的水平和变化。对患者变化中治疗师作用的初步估计表明，4%的一般症状困扰（GSI）变化、近21%的IIP总体评分变化和28%的GAF增长可归因于治疗师差异。结果还表明，某些治疗师的自我认知与患者的治疗结果明显相关。例如，治疗师在实践中被称为专业自我怀疑（PSD）的一种困难上的得分（表示对一个人的专业效能的怀疑）与IIP总体得分的变化呈正相关。尽管治疗师的影响不一定在预期的方向上发挥作用，但治疗师自我报告的功能对于理解个体治疗师如何促进治疗变化具有价值。
The need for psychotherapy research to understand the therapist effect has been emphasized in several studies. In a large naturalistic study (255 patients, 70 therapists), this topic was addressed using therapists' self-assessed difficulties in practice and interpersonal functioning in therapeutic work as predictors of patient outcome in three conventional outcome measures. Three-level growth curve analyses were employed to assess whether the therapist characteristics, measured by the Development of Psychotherapists Common Core Questionnaire (Orlinsky & Ronnestad, 2005), predicted the level of and change in patient symptom distress (SCL-90R), interpersonal problems (IIP-64), and observer-rated global functioning (GAF). Preliminary estimates of therapist effects in patient change indicated that 4% of change in general symptom distress (GSI), almost 21% of change in IIP global scores, and 28% of growth in GAF could be attributed to therapist differences. The results also demonstrated that certain therapist self-perceptions were clearly related to patient outcome. For example, therapists' scores on a type of difficulty in practice called Professional self-doubt (PSD) (denoting doubt about one's professional efficacy) were positively associated with change in IIP global scores. It is suggested that therapists' self-reported functioning can be of value in understanding how individual therapists contribute to therapeutic change although their influence is not necessarily exerted in expected directions.