Affection for patients as a factor in therapists' outcome judgments

Abstract

This study was concerned with psychotherapists' evaluations of the outcome of therapy. Staff and resident psychiatrists employed in 23-item questionnaire to rate the seccess of psychotherapy with 85 of their inpatients. These were patients for whom psychotherapy constituted a significant part of the treatment that they received in the hospital. The therapists' responses to the questionnaire items were intercorrelated. The results indicated that a major aspect of a psychotherapist's judgment of the success of treatment-as these judgments usually are employed in current psychotherapy research-is the therapist's affective reaction to the patient, Better-liked patients were viewed as having improved more. However, when the therapists' responses were subjected to factor analysis, independent Improvement and Affection factors emerged. It is suggested that when therapists' ratings of success are used in psychotherapy research they should be treated or refined statistically to minimize potential confounding with their affection for patients.

Responsiveness in psychotherapy.

“…For example, knowing that the alliance predicts the outcome allows one to ask, “What processes contribute to the alliance?”— perhaps a more tractable question than “What processes contribute to long-term outcome?” Considering placement on evaluative dimensions as intermediate manifestations sidesteps the puzzle of whether they represent cause or effect. As others have noted, strong therapeutic alliances or therapists' liking for their clients may be early indexes of positive outcome (DeRubeis & Feeley, 1990; Martin, Sterne, & Karwisch, 1976). Similarly, a therapist's competence may appear greater with a client who is improving for other reasons.…”