Psychotherapists' self-reports of their interpersonal functioning and difficulties in practice as predictors of patient outcome

Nissen‐Lie, Helene A.; Monsen, Jon T.; Ulleberg, Pål; Rønnestad, Michael Helge

doi:10.1080/10503307.2012.735775

Cited by 98 publications

(84 citation statements)

References 65 publications

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“…For reasons of better comparability between the two perspectives, we applied the factor structure from the therapist perspective on both perspectives. All variables were centred to the mean, which has been recommended as a helpful device in the interpretation of the results and in the reduction of multicollinearity by several authors (Heck et al, 2010;Hox, 2010;Nissen-Lie, Monsen, Ulleberg, & Rønnestad, 2013). We applied the MLM in line with the recommendations of Heck, Thomas, and Tabata (2010) and Field (2009).…”

Section: Multilevel Modellingmentioning

confidence: 99%

The Individual Therapy Process Questionnaire: Development and Validation of a Revised Measure to Evaluate General Change Mechanisms in Psychotherapy

Mander

Schlarb

Teufel

et al. 2014

Clin Psychology and Psychoth

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There is a dearth of measures specifically designed to assess empirically validated mechanisms of therapeutic change. To fill in this research gap, the aim of the current study was to develop a measure that covers a large variety of empirically validated mechanisms of change with corresponding versions for the patient and therapist. To develop an instrument that is based on several important change process frameworks, we combined two established change mechanisms instruments: the Scale for the Multiperspective Assessment of General Change Mechanisms in Psychotherapy (SACiP) and the Scale of the Therapeutic Alliance-Revised (STA-R). In our study, 457 psychosomatic inpatients completed the SACiP and the STA-R and diverse outcome measures in early, middle and late stages of psychotherapy. Data analyses were conducted using factor analyses and multilevel modelling. The psychometric properties of the resulting Individual Therapy Process Questionnaire were generally good to excellent, as demonstrated by (a) exploratory factor analyses on both patient and therapist ratings, (b) CFA on later measuring times, (c) high internal consistencies and (d) significant outcome predictive effects. The parallel forms of the ITPQ deliver opportunities to compare the patient and therapist perspectives for a broader range of facets of change mechanisms than was hitherto possible. Consequently, the measure can be applied in future research to more specifically analyse different change mechanism profiles in session-to-session development and outcome prediction. Key Practitioner Message This article describes the development of an instrument that measures general mechanisms of change in psychotherapy from both the patient and therapist perspectives. Post-session item ratings from both the patient and therapist can be used as feedback to optimize therapeutic processes. We provide a detailed discussion of measures developed to evaluate therapeutic change mechanisms.

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Section: Multilevel Modellingmentioning

confidence: 99%

The Individual Therapy Process Questionnaire: Development and Validation of a Revised Measure to Evaluate General Change Mechanisms in Psychotherapy

Mander

Schlarb

Teufel

et al. 2014

Clin Psychology and Psychoth

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“…That situation has changed substantially, with evidence that some of our emotional states are associated with therapy processes and outcomes. At a general level, Westra, Aviram, Connors & Kertes (2012) and Nissen-Lie, Monsen, Ulleberg & Rønnestad (2013) have shown that our emotional reactions to patients can facilitate or hinder therapy. For example, Beutler, Crago & Arizmendi (1986) have concluded that therapists who are lower in emotional disturbance have more consistent patient outcomes.…”

Section: Our Emotionsmentioning

confidence: 99%

Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track

Waller

Turner

2016

Behaviour Research and Therapy

202

147

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Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. AbstractTherapist drift occurs when clinicians fail to deliver the optimum evidence-based treatment despite having the necessary tools, and is an important factor in why those therapies are commonly less effective than they should be in routine clinical practice. The research into this phenomenon has increased substantially over the past five years. This review considers the growing evidence of therapist drift. The reasons that we fail to implement evidence-based psychotherapies are considered, including our personalities, knowledge, emotions, beliefs, behaviors and social milieus. Finally, ideas are offered regarding how therapist drift might be halted, including a cognitive-behavioral approach for therapists that addresses the cognitions, emotions and behaviors that drive and maintain our avoidance of evidence-based treatments.Keywords: therapist drift; psychotherapies; evidence-based practice; training; cognitivebehavioral therapy Therapist drift redux 3 Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track There are different reasons why evidence-based therapies might be delivered poorly, such as clinicians being inadequately trained in the therapy in question (e.g., Royal College of Psychiatrists, 2013) or working in a setting that does not permit the implementation of the necessary methods (e.g., not being permitted to provide the necessary number of sessions).Among those reasons is one that is centred in our own practice -therapist drift (Waller, 2009). Therapist drift can be conceptualised as our failure to deliver treatments that we have been trained to deliver, or failure to deliver them adequately, even where resources exist to allow us to do so. Such failure can be a consciously or an unconsciously-driven course of action. Regardless, it has the same consequence -the patient receives treatment that deviates significantly from the evidence-base, reducing their chances of improvement or recovery. This paper will review the substantial recent evidence fo...

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“…In one influential study, Nissen-Lie et al (2013) found that the most successful therapists in their sample were also the ones who exhibited the most professional self-doubt. Within the case of Mr. R, professional self-doubt runs like a constant thread through the self-description of the author.…”

Section: Discussionmentioning

confidence: 99%

Narrative Case Studies and Practice-Based Learning: Reflections on the Case of "Mr. R"

McLeod¹

2016

PCSP

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Narrative case studies tell the story of therapy from the point of view of the client or therapist. Murase's (2015) case of "Mr. R" provides a powerful example of the potential of this form of case inquiry, as a means of enabling reflection and deeper understanding around the practice and process of therapy. The distinctive contribution of the case of Mr. R is discussed in relation to the personal learning of the author in respect of a series of domains: working with the contextual and cultural meaning of the client's issues, creating corrective everyday life interventions, repairing therapist-induced ruptures in the therapeutic alliance, and developing new understandings of the process of client internalisation of the image of the therapist. Theoretical implications of the case are explored, and some suggestions are offered around the further development of narrative case study methods and the concept of therapist wisdom.Key words: culture; everyday life; exemplar study; internalization; narrative; personal meaning; theoretical fluidity; therapy process; wisdom ______________________________________________________________________________ The case of Mr. R offers one of the relatively few English-language examples of the work of Dr Kayoko Murase (2015), for many years one of the most influential figures in psychotherapy in Japan. In addition, this case acts as an example of the rich tradition of case study inquiry that forms a key part of the evidence base for therapy theory and practice in that country. This case therefore possesses cultural and professional significance beyond its account of how therapy unfolded with a troubled young man. Constructing a commentary on this case has been a demanding task, because of the rich, multi-layered nature of the material that has been provided. In the following sections, I offer reflections on three key dimensions of the case: the therapy case study as a form of narrative inquiry, practice-based learning arising from reflection on the case of Mr. R and implications for theory.

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Psychotherapists' self-reports of their interpersonal functioning and difficulties in practice as predictors of patient outcome

Cited by 98 publications

References 65 publications

The Individual Therapy Process Questionnaire: Development and Validation of a Revised Measure to Evaluate General Change Mechanisms in Psychotherapy

The Individual Therapy Process Questionnaire: Development and Validation of a Revised Measure to Evaluate General Change Mechanisms in Psychotherapy

Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track

Narrative Case Studies and Practice-Based Learning: Reflections on the Case of "Mr. R"

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