Role of psychotherapists in treatment effectiveness

Date:
November 19, 2021
Source:
University of Massachusetts Amherst
Summary:
New research shows that different psychotherapists use common
treatment processes to varying benefits for patients.



FULL STORY ==========================================================================
New research at the University of Massachusetts Amherst shows that
different psychotherapists use common treatment processes to varying
benefits for patients.


==========================================================================
The findings, published in the Journal of Consulting and Clinical
Psychology, ultimately may lead to more personalized clinical practices
and trainings for therapists to help maximize their therapeutic impact
and improve patient outcomes.

"Research has tended to focus on the contributions of the patient or
treatment type to therapy outcomes, which makes sense in a lot of ways,
but unfortunately the therapist contribution has been somewhat neglected,"
says lead author Alice Coyne, now a post-doctoral researcher at Case
Western Reserve University and a Ph.D. graduate of UMass Amherst. "Our
current trainings, which are often standardized across therapists, tend
not to promote consistent improvements in patient outcomes. Instead, we
believe that personalizing training to therapists' unique strengths and weaknesses could enhance training outcomes down the line." Working with co-author Michael Constantino, professor of clinical psychology and
director of the Psychotherapy Research Lab at UMass Amherst, Coyne
initially conducted the research as part of her Ph.D. dissertation,
which received the 2020 dissertation award from the Society for the
Exploration of Psychotherapy Integration.

"Her work is the first of its kind, and it will blaze a trail in our
field," Constantino predicts.

As her dissertation's first aim, Coyne was interested in testing the
prediction that patients experience more symptomatic and functional
improvement in psychotherapy when a higher-quality patient-therapist
alliance exists, as well as when the patient has a more positive
expectation for change.

For the second aim, Coyne was interested in seeing if these associations differed based on who the therapist is. "A given technique in the hands
of one therapist may look very different than that same technique
in the hands of another therapist," Coyne says. "To put it simply,
one therapist may use their relationship with their patients as a
key means to facilitate improvement; whereas for another therapist,
their relationships with patients may be less important for patient
improvement than their use of other strategies, such as cultivating
positive expectations for change." Finally, for the third aim, Coyne
looked at whether certain therapist characteristics predict which
therapists tend to use relationship and belief processes to more
therapeutic benefit across their caseloads.

To test these questions, the researchers analyzed data from 212 adults
who were treated by 42 psychotherapists as part of a randomized trial
that compared case-assignment methods in community-based mental health
care. Throughout treatment, which varied in length and type, patients repeatedly completed surveys that measured their alliance quality with
the therapist and their expectations for improvement.

Coyne and Constantino correctly hypothesized that, in general, better
alliance quality and more positive outcome expectation associated with
better treatment outcomes. Also, as predicted, therapists exhibited
different strengths and weaknesses in their use of relationship and
belief processes.

Finally, there was preliminary support that the therapists who used the alliance most effectively to promote patient improvement are the ones
"... who are humbler in assessing their own alliance-fostering abilities,"
the paper states.

Humbly know thyself may be one helpful takeaway from the research. "If
you learn the things that you do particularly well as a therapist,
then you can tailor your practice and play to your strengths," Coyne says.

========================================================================== Story Source: Materials provided by
University_of_Massachusetts_Amherst. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Alice E. Coyne, Michael J. Constantino, James F. Boswell, David
R. Kraus.

Therapist-level moderation of within- and between-therapist
process- outcome associations.. Journal of Consulting and Clinical
Psychology, 2021; DOI: 10.1037/ccp0000676 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/11/211119155619.htm

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