THE RELATIONSHIP OF PATIENT DIFFICULTY TO THERAPIST PERFORMANCE IN INTERPERSONAL PSYCHOTHERAPY OF DEPRESSION
THE RELATIONSHIP OF PATIENT DIFFICULTY TO THERAPIST PERFORMANCE IN INTERPERSONAL PSYCHOTHERAPY OF DEPRESSION
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DOI：
10.1016/0165-0327(87)90029-2
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发表时间：
1987-05-01
影响因子：
6.6
通讯作者：
WEISSMAN, MM
中科院分区：
文献类型：
--
作者：
FOLEY, SH;OMALLEY, S;WEISSMAN, MM
最近完成的NIMH抑郁症治疗合作研究计划（Elkin et al. 1986）证实了人际心理治疗（IPT）在治疗非卧床抑郁症中的疗效。增强或阻碍治疗给药的因素界定了有效的患者护理，因此应加以理解。本报告探讨了治疗前患者的态度和治疗患者的困难，以治疗师的能力，胜任进行IPT的关系，使用的数据从IPT的培训计划。假设是患者建立关系和承担治疗任务要求的能力和意愿会影响治疗师的治疗能力。患者的困难被认为是密切相关的治疗师和监督者的判断治疗师的表现在IPT会议：当患者更困难，治疗师被判定为表现更差。 患者对潜在治疗结果的预先存在的负面期望与患者困难和较差的治疗师表现相关，而呈现的治疗水平则无关。因此，似乎是患者参与富有成效的治疗关系的能力，而不是目前问题的严重程度影响了治疗师胜任执行IPT的能力。关于患者的困难治疗师的表现评级的关系的调查结果表明，患者的困难，应考虑在评估治疗师的能力，无论是治疗效果的研究或临床监督和培训一般。
The efficacy of Interpersonal Psychotherapy (IPT) in the treatment of ambulatory major depression was demonstrated in the recently completed NIMH Treatment of Depression Collaborative Research Program (Elkin et al. 1986). Factors which enhance or impede the administration of the treatment delimit effective patient care and should therefore be understood. This report examines the relationship of pretreatment patient attitudes and intreatment patient difficulty to the ability of therapists to competently conduct IPT, using data from a training program in IPT. The hypothesis was that the patient''s ability and willingness to establish a relationship and undertake the task demands of therapy would influence the therapist''s ability to administer treatment. Patient difficulty was found to be strongly related to both therapists'' and supervisors'' judgements of therapist performance during IPT sessions: when patients were more difficult, therapists were judged to have performed more poorly. Patients'' preexisting negative expectations about the potential outcome of treatment were associated with patient difficulty and poorer therapist performance, while the level of presenting symptomatology was not. Thus, it appears that the patient''s ability to engage in a productive therapeutic relationship rather than the severity of this presenting problems influenced the therapist''s ability to competently perform IPT. The findings regarding the relationship of patient difficulty to ratings of therapist performance suggest that patient difficulty should be taken into account in assessing therapist competence, whether for studies of therapeutic efficacy or for clinical supervision and training in general.