Abstract

Objective Studies examining the unique contribution that the therapist has on outcomes (i.e., “therapist effects”) have increased in recent years. Therapist effects are believed to occur via how the therapist’s interpersonal and intrapersonal qualities influence the therapeutic relationship, which in turn influences outcomes. The current study focused on the extent to which professional self-doubt, counseling self-efficacy, and humility are therapist qualities that influence treatment outcomes. Methods: Data were collected from 46 therapists at a multi-site community behavioral health organization. Therapists completed measures of therapist characteristics. Therapists’ responses were matched with de-identified archival client data (N = 1, 817) that contained an outcome and alliance measure administered every session. Multilevel modeling was used to determine the extent to which therapists’ personal characteristics predicted client outcomes. Results: Results of the unconditional model for the alliance measure indicated a lack of growth in alliance scores across treatment. Approximately 5% of the variance in rate of growth for treatment outcome was between therapists. When controlling for the effects of counseling self-efficacy, professional self-doubt was marginally significant. When counseling-self-efficacy was removed from the model, professional self-doubt was no longer marginally significant. Conclusion: The findings highlight the complexity of therapist effects and the need for future research on this topic.

摘要

客观近年来，研究治疗师对结果（即“治疗师效应”）的独特贡献的研究有所增加。治疗师的效果被认为是通过治疗师的人际关系和内省品质如何影响治疗关系而产生的，而治疗关系又会影响结果。目前的研究重点关注职业自我怀疑、咨询自我效能和谦逊在多大程度上是影响治疗结果的治疗师品质。方法：数据是从一家多站点社区行为健康组织的 46 名治疗师那里收集的。治疗师完成了治疗师特征的测量。治疗师的回答与去识别化的档案客户数据相匹配（N = 1, 817)，其中包含每届会议实施的成果和联盟措施。多层次模型被用来确定治疗师的个人特征在多大程度上预测客户的结果。结果：联盟测量的无条件模型的结果表明整个治疗的联盟分数没有增长。大约 5% 的治疗结果增长率差异发生在治疗师之间。在控制咨询自我效能感的影响时，职业自我怀疑略显重要。当咨询自我效能从模型中移除时，职业自我怀疑不再具有边缘意义。结论：研究结果突出了治疗师效果的复杂性以及未来对该主题进行研究的必要性。