Background and objectives

Clinicians often fail to deliver the best psychological treatments available, especially if they perceive their patients as fragile or vulnerable. This fragility might be interpreted by clinicians through their internalised gender stereotypes (e.g. female patients are less resilient to a demanding treatment) or according to their patients' emotional state (e.g. the patient is too delicate to endure the most stress-inducing aspects of therapy). The aim of this study was to test experimentally whether patients’ characteristics influenced therapy delivery. Some clinician characteristics were also considered.

Methods

This was an experimental, vignette-based study that evaluated clinicians' likelihood of utilizing several techniques commonly used in CBT by manipulating patients' mood and gender. Clinicians’ personality traits were also included as covariates.

Results

Anxious patients were the most likely to receive the techniques, especially exposure and other behavioural techniques. Therapists delivered more techniques to male patients, while angry and calm female patients were the least likely to receive the techniques. Therapists were more likely to deliver talking techniques to female patients. Clinicians’ firmness and empathy had an effect on CBT delivery.

Limitations

Future vignette-based studies should validate and pilot the vignettes. Technique clustering should also be based in factor analysis or similar methods. Direct observational methods might be more reliable than self-report.

Conclusion

The findings suggest that clinicians treat their patients differently, either consciously or inadvertently. These differences are likely to be related to clinicians’ own concerns and gender stereotypes about their patients.

中文翻译：

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患者的情绪和性别会影响我们提供 CBT 的方式吗？一项关于患者和临床医生特征相关性的实验性、基于小插曲的研究

背景和目标

临床医生通常无法提供最好的心理治疗，尤其是当他们认为患者脆弱或易受伤害时。这种脆弱性可能会被临床医生通过其内在的性别刻板印象（例如，女性患者对苛刻的治疗缺乏弹性）或根据患者的情绪状态（例如，患者太脆弱而无法承受治疗中最容易引起压力的方面）来解释. 本研究的目的是通过实验测试患者的特征是否影响治疗实施。还考虑了一些临床医生特征。

方法

这是一项基于小插曲的实验性研究，通过操纵患者的情绪和性别来评估临床医生利用 CBT 中常用的几种技术的可能性。临床医生的人格特征也被列为协变量。

结果

焦虑的患者最有可能接受这些技术，尤其是暴露和其他行为技术。治疗师向男性患者提供了更多技术，而愤怒和冷静的女性患者最不可能接受这些技术。治疗师更有可能向女性患者提供谈话技巧。临床医生的坚定和同理心对 CBT 的实施有影响。

限制

未来基于小插图的研究应该验证和试点小插图。技术聚类也应该基于因子分析或类似方法。直接观察方法可能比自我报告更可靠。

结论

研究结果表明，临床医生有意或无意地对待患者的方式不同。这些差异可能与临床医生自身的担忧和对患者的性别刻板印象有关。