ABSTRACT

Background:

Changes during psychotherapy often include sudden symptom improvements, called sudden gains (SGs), which have been identified as being superior to gradual symptom change with regard to treatment success. This study investigates the role of therapists in initiating and/or consolidating SGs.

Methods:

The analyses are based on a sample of patients (N = 1937) who were seen by 155 therapists and received individual psychotherapy at a university outpatient clinic. First, the therapist effect (TE) on SG was investigated using multilevel modeling (MLM). Second, MLM was used to explore the relative importance of patient and therapist variability in SGs as they relate to outcome.

Results:

The TE on SGs accounted for 1.8% of variance, meaning that therapists are accountable for inter-individual differences in their patients’ likelihood to experience SGs. Furthermore, results revealed a significant effect of SGs on outcome for both levels, while therapist differences regarding the consolidation of SGs were not significant.

Conclusions:

The analyses indicated that some therapists are better in facilitating and initiating SGs. The process of triggering SGs seems to be a therapist skill or competence, which opens up an additional pathway to positive outcomes that could be used to improve clinical training.

中文翻译：

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一些治疗师是否比其他治疗师更善于促进和巩固突然的收获？

摘要

背景：

心理治疗期间的变化通常包括突然的症状改善，称为突然获得（SG），在治疗成功方面已被确定为优于逐渐的症状改变。本研究调查了治疗师在启动和/或巩固 SG 中的作用。

方法：

分析基于患者样本 ( N  = 1937)，这些患者在大学门诊接受了 155 名治疗师的诊治并接受了个人心理治疗。首先，使用多层次建模 (MLM) 研究了治疗师对 SG 的影响 (TE)。其次，MLM 用于探索患者和治疗师变异在 SG 中与结果相关的相对重要性。

结果：

SG 的 TE 占方差的 1.8%，这意味着治疗师应对患者经历 SG 可能性的个体差异负责。此外，结果显示 SGs 对两个级别的结果都有显着影响，而治疗师在 SGs 巩固方面的差异不显着。

结论：

分析表明，一些治疗师在促进和启动 SG 方面做得更好。触发 SG 的过程似乎是一种治疗师的技能或能力，它开辟了一条通往积极成果的额外途径，可用于改善临床培训。