OBJECTIVE The therapist effect has been demonstrated in various studies. However, studies on putative therapist characteristics show heterogeneous results. Although the majority of studies have solely examined effects between therapists, a growing interest in effects within therapists has emerged. However, it remains unclear whether therapist characteristics are rather a state-like than a trait-like phenomenon. The main aim of the present study is to test whether clinical microskills as well as correct application of techniques and strategies (both between and within therapists) predict across-session change of symptom severity in a large naturalistic data set. METHOD The results are based on 398 patients and 48 therapists who treated 5-17 patients each. Clinical microskills and correct application of techniques/strategies were rated using the Inventory of Therapeutic Interventions and Skills, and symptom severity was assessed with the Hopkins Symptom Checklist-11. RESULTS Results demonstrated significant within- and between-therapist variability in clinical microskills and correct application of techniques/strategies, and no change over the course of treatment in both variables. Moreover, correct application of techniques/strategies was significantly associated with symptom improvement within, but not between therapists. In addition, higher treatment difficulty as well as an interaction between treatment difficulty and correct application of techniques/strategies were significantly associated with symptom improvement. Clinical microskills were neither predictive of symptom improvement within nor between therapists. CONCLUSIONS These results provide initial evidence that not the therapist's average correct application of techniques/strategies is important, but rather how correctly they use a technique with a specific patient. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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临床微观技能与技术/策略的正确应用之间的关联内部和之间：纵向多层次方法。

目的 治疗师的效果已在各种研究中得到证实。然而，关于假定治疗师特征的研究显示出异质性的结果。尽管大多数研究只检查了治疗师之间的效果，但对治疗师内部效果的兴趣日益浓厚。然而，目前尚不清楚治疗师的特征是否更像是一种状态而不是像特质的现象。本研究的主要目的是测试临床微观技能以及技术和策略的正确应用（在治疗师之间和治疗师内部）是否可以预测大型自然数据集中症状严重程度的跨疗程变化。方法 结果基于 398 名患者和 48 名治疗师，每人治疗 5-17 名患者。使用治疗干预和技能清单对临床微观技能和技术/策略的正确应用进行评级，并使用霍普金斯症状检查表 11 评估症状严重程度。结果 结果表明，治疗师内部和治疗师之间在临床微观技能和技术/策略的正确应用方面存在显着差异，并且两个变量在治疗过程中没有变化。此外，技术/策略的正确应用与治疗师内部的症状改善显着相关，但与治疗师之间的症状改善无关。此外，较高的治疗难度以及治疗难度与正确应用技术/策略之间的相互作用与症状改善显着相关。临床微观技能既不能预测治疗师内部或治疗师之间的症状改善。结论 这些结果提供了初步证据，表明治疗师对技术/策略的平均正确应用并不重要，而是他们对特定患者使用技术的正确程度。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。