Therapists' professional and personal characteristics as predictors of outcome in short- and long-term psychotherapy

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• 作者：Erkki Heinonen^a ; Olavi Lindfors^a ; Maarit A. Laaksonen^a ; Paul Knekt^a ; ^b ; ^{paul.knekt@thl.fi}
• 关键词：Anxiety disorders ; Depressive disorder ; Psychotherapy ; Effectiveness ; Psychotherapists
• 刊名：Journal of Affective Disorders
• 出版年：2012
• 期刊代码：141_01650327
• 类别：med
• 出版时间：May, 2012
• 卷：138
• 期：3
• 页码：301-312
• 文件大小：471 K

摘要

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 20-46 years, 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 3 years. Therapies were provided by 55 volunteering therapists with at least 2 years 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 months after start of treatment with the Symptom Check List, Global Severity Index (SCL-90-GSI).

Results

Active, engaging, and extroverted therapists produced a faster symptom reduction in short-term therapy than in long-term therapy. More cautious, non-intrusive therapists generated greater benefits in long-term therapy during the 3-year follow-up. Therapists' lower confidence and enjoyment in therapeutic work predicted poorer outcomes in short-term therapy in the long run.

Limitations

Generalizability may be limited due to relatively experienced therapists.

Conclusions

Therapist characteristics apparently are important determinants of effectiveness of short- and long-term psychotherapy. If confirmed in future studies, results may be applied in training and supervision of therapists as well as in fitting therapy forms with therapist dispositions to maximize treatment benefits.