What Therapist Factors Don’t Impact Outcomes? Research has repeatedly shown that age, gender, ethnicity/culture, profession/training, theoretical orientation, and experience are not related to therapist effectiveness (Beutler et al, 2004; Wampold & Brown, 2005). What Therapist Behaviors Hurt Outcomes?
Full Answer
How can counselors improve the therapeutic relationship with clients?
There are several techniques that counselors can adopt to improve the therapeutic relationship. Creating a bond requires building warmth and trust within the relationship. The client should feel heard, supported, and able to connect deeply with the therapist when needed (Knox & Cooper, 2015).
What is the relationship between the therapist and patient?
In 1913, Sigmund Freud hypothesized that the relationship between the therapist and patient was a key component of successful treatment. Since that time, research has shown that the quality of this relationship (the "therapeutic alliance," as it is called) is the strongest predictor of whether or not therapy is successful.
Does the therapeutic relationship affect treatment outcome?
These studies, which used diverse patient groups (children and adults, in-patients and out-patients) treated for all types of problems (i.e. depression, anxiety, drug abuse, work and social problems), all show the importance of the therapeutic relationship on treatment outcome.
Are beginning therapists better at forming therapeutic relationships than experienced therapists?
Many beginning therapists are as skilled as their more experienced counterparts at forming good therapeutic relationships. However, studies show that experienced therapists are better at forming relationships with those patients who have struggled in past relationships.
Which factor is most predictive of positive outcomes in therapy?
The most powerful of those common factors have been referred to as the “therapeutic alliance,” referring to the bond between client and therapist. Study after study has shown that the quality of the relationship between client and therapist is the only reliable and the most powerful predictor of a positive outcome.
What is a factor that might inhibit the use of effective assessment tools?
What is a factor that might inhibit the use of effective assessment tools? Most assessment tools are expensive to administer and evaluate. A campus newspaper publishes an Exam Anxiety test that newspaper staffers put together one evening just before their publishing deadline.
Which of the following is the most important determinant of the effectiveness of psychotherapy?
Which of the following is the most important determinant of the effectiveness of psychotherapy? trying to get the patient to identify irrational and self-defeating thoughts.
Which clinical therapist identified the three essential features of all forms of therapy?
According to clinical theorist Jerome Frank, all forms of therapy have three essential features: A sufferer who seeks relief from the healer.
What factors affect assessment?
Factors that impact or influence performance in a testing situation include client/patient/student factors, clinician factors, environmental factors, and those involving the actual testing process itself. This brief highlights these factors for both adult clients and children/students.
What are the other factors that affect your test performance?
Factor 1: Panic. Panic is irrational, self-made, and self-defeating. ... Factor 2: Carelessness. ... Factor 3: Lack of Focus. ... Factor 4: Excessive Anxiety. ... Factor 5: Cramming. ... Test Performance 2. ... Factor 7: Lack of Exercise. ... Factor 8: Low Motivation.More items...
What are the factors that come into play in determining the effectiveness of therapy?
The effectiveness of a particular therapeutic approach can be assessed in three ways: client testimonials, providers' perceptions, and empirical research.Client Testimonials. Clients who get treatment for psychological problems often testify to their effectiveness. ... Providers' Perceptions. ... Empirical Research.
What determines the effectiveness of psychotherapy?
The success of psychotherapy can be determined by the combination of three factors, namely, evidence-based treatment unique to one's distress, the psychologist's clinical expertise, and the client's characteristics, values, culture, and preferences.
What is a critical factor in determining the success of psychotherapy?
Regardless of which type of psychotherapy an individual chooses, one critical factor that determines the success of treatment is the person's relationship with the psychologist or therapist.
What are the 6 models of abnormality?
Contents Biological (medical) model. 1.1 Evaluation of the biological (medical) model. Behavioral model. 2.1 Evaluation of the behavioural model. Cognitive model. Psychodynamic model.
What are the 4 models of psychopathology?
Which do you think is the most accurate approach to psychopathology?The biological approach.The behavioural approach.The psychodynamic approach.The cognitive approach.
What features are common to abnormal psychological functioning?
There are four common features to abnormal psychological functioning: deviance (different, extreme, unusual, perhaps even bizarre), distress (unpleasant and upsetting to the person), dysfunction (interfering with the person's ability to conduct daily activities in a constructive way) and dangerous.
What are the factors that break down a therapy alliance?
Many factors can break down the therapy alliance, such as disagreement on treatment goals, the patient’s misinterpretation of something the therapist has said or a mistrust of the therapeutic process. Research shows that resolving these difficulties, known as therapy ruptures, can lead to better outcomes ( Psychotherapy, Vol. 55, No. 4, 2018).
What is the shift in psychotherapy?
One big shift in psychotherapy in recent years is toward greater mutuality—the notion that psychotherapy is a two-way relationship in which the therapist and client are equal partners in the therapy process.
What is responsiveness in therapy?
Responsiveness is also related to understanding clients as individuals— being attuned to their personality traits, conflicts, quirks and motivations , says Orya Tishby, PsyD, a clinical lecturer and researcher at The Hebrew University of Jerusalem, who co-edited “Developing the Therapeutic Relationship” (APA, 2018).
Who developed the outcome rating scale?
Other psychologists have since developed shorter measures for the same purpose, notably the Outcome Rating Scale and the Session Rating Scale, developed by Scott D. Miller, PhD, Barry L. Duncan, PsyD, and colleagues.
Can a patient be in psychotherapy if they don't have negative feelings?
Handling negative emotions. Patients probably wouldn’t be in psychotherapy if they didn’t have negative feelings to work through. Unfortunately, it can be difficult for clinicians to have to address patients’ negative states repeatedly.
What is the role of alliance in therapy?
The therapeutic relationship is regarded as an important factor that increases the likelihood that the client will listen to the therapist and allow for the implementation of behavioural techniques (Sweet, 1984).
What does a positive alliance mean in CBT?
Thus, a positive alliance may also be an indicator that things are going well in therapy overall.
What is an alliance in CBT?
On the other hand, the alliance might allow for a client’s acceptance of a CBT therapist’s techniques, such as cognitive interpretations and restructuring. As such, the alliance might be reflective of positive outcome, rather than causally related.
What is cognitive behavior therapy?
Cognitive Behavioural Therapy (CBT) is the form of treatment that has gathered the most empirical support for its efficacy to date. Its efficacy in treating a variety of psychological disorders in adults has been well documented (see Butler, Chapman, Forman, & Beck, 2006). In fact, 94% of “well-established” empirically supported treatments (see Hunsley, Dobson, Johnston, & Mikail, 1999) are cognitive behavioural therapies. CBT is based on the premise that psychopathology is caused by dysfunctional thinking patterns, that in turn cause emotional and behavioural difficulties (Beck, Emery, & Greenberg, 1985). Thus, treatment is designed to modify dysfunctional cognitions and maladaptive behaviours, and to alter the manner in which people interpret and act on negative emotions. Treatment is delivered via a psychoeducational approach, in which the therapist begins by providing a rationale for CBT to the client and explains the relationship between cognition, affect, and behaviour (Hamilton & Dobson, 2002). Treatment is focused on solving current problems, is structured and directive, and is typically brief and time-limited (Beck, Emery, & Greenberg, 1985).
Does meta analysis include CBT?
The meta-analytic reviews that have examined rater effects on alliance and outcome thus far have not included many CBT studies in their data set. For example, in a review of 90 studies published between 1976 and 2000 (Horvath & Bedi, 2002) included only 5 cognitive therapy studies.
Is alliance related to outcome?
Given that, overall, the alliance seems to be often moderately related to outcome, and given that its role within CBT has not been extensively empirically examined, a meta-analysis examining at the effects of alliance within CBT is necessary.
Did Rogers examine the therapist's contribution to the alliance?
Furthermore, Rogers only examined the therapist’s contribution to the alliance. Some reviews, however (e.g., Gelso & Carter, 1985), concluded that Rogers’ therapist-offered conditions only account for part of the complex and, at times, interactive factors that contribute to positive outcome (Horvath & Symonds, 1991).
How to Establish a Healthy Therapeutic Alliance
All therapists require a depth of relating with their clients. In Cognitive-Behavioral Therapy ( CBT ), this may be described as a close relationship, while for person-centered and experiential therapy, it is considered core to the treatment (Knox & Cooper, 2015).
Components of the Therapeutic Relationship
There are several crucial factors and components to building and maintaining a therapeutic relationship.
2 Examples of a Supportive Therapeutic Alliance
A supportive therapeutic alliance is crucial to client perseverance and a positive treatment outcome (Ardito & Rabellino, 2011).
10 Skills of Effective Therapists
International research about what makes a great therapist explored what such professionals were doing, thinking, and feeling when they were at their most effective (Novotney, 2013).
3 Helpful Techniques for Counselors
There are several techniques that counselors can adopt to improve the therapeutic relationship.
6 Communication Tips
When the therapeutic alliance appears to fail, it is worthwhile considering your approach to communication (Knox & Cooper, 2015).
Assessing Your Relationship: 2 Questionnaires & Scales
Client feedback can help therapists recognize psychological distress and improvements to wellbeing (Knox & Cooper, 2015).
What are the characteristics of a therapeutic relationship?
Qualities of a good therapeutic relationship: 1 Mutual trust, respect, and caring 2 General agreement on the goals and tasks of the therapy 3 Shared decision-making 4 Mutual engagement in "the work" of the treatment 5 The ability to talk about the "here-and-now" aspects of the relationship with each other 6 The freedom to share any negative emotional responses with each other 7 The ability to correct any problems or difficulties that may arise in the relationship
What factors affect whether a treatment is successful?
Research shows that many factors affect whether treatment is successful, including the severity of the problem (s) being treated, the patient's belief that the counseling will work and the skill level of the therapist. However, research over the past fifty years has demonstrated that one factor — more than any other — is associated ...
What is the strongest predictor of whether or not a therapy is successful?
Since that time, research has shown that the quality of this relationship (the "therapeutic alliance," as it is called) is the strongest predictor of whether or not therapy is successful. Strikingly, the quality of the therapeutic relationship appears critical to treatment success no matter what type of treatment is studied.
What is therapeutic relationship?
Historically, study of the therapeutic relationship has focused solely on the patient's relationship with the therapist. However, research conducted at The Family Institute at Northwestern University by myself and Dr. William Pinsof demonstrates the importance of expanding this definition to include the influence of significant other people in the patient's life. For example, in individual therapy, support of the treatment by the patient's significant others (family members, spouse, close friends) was associated with successful outcome. In couple therapy, the extent to which the couple agreed with each other on treatment tasks, goals and bonds predicted whether therapy would be successful.
What to do if you have difficulties with a therapist?
If you are having difficulties with your therapist, it is important to talk about that directly with your therapist. If you have questions or concerns about any part of the treatment, do not hesitate to discuss them with your therapist. Open, honest communication is a very healthy strategy for resolving difficulties.
What is the general agreement in therapy?
General agreement on the goals and tasks of the therapy. Shared decision-making. Mutual engagement in "the work" of the treatment. The ability to talk about the "here-and-now" aspects of the relationship with each other. The freedom to share any negative emotional responses with each other.
Is forming good relationships with patients a function of therapist training?
Research shows that the ability to form good relationships with patients is not simply a function of therapist training or experience level. Many beginning therapists are as skilled as their more experienced counterparts at forming good therapeutic relationships.
Overview
Fostering Mutuality and Collaboration
Being Flexible and Responsive
- Also critical to outcomes is a therapist’s ability to tailor treatment to patients’ individual characteristics, such as their cultural background, therapy preferences, attachment style, religious or spiritual beliefs, gender identity and sexual orientation—“to select different methods, stances and relationships according to the patient and the context,” as Norcross puts it. (The topic of res…
Using Feedback
- Another important way to boost the therapeutic relationship—as well as patient outcomes—is by gathering patient feedback and incorporating it into treatment. A widely studied and validated tool used by psychologists is the Outcome Questionnaire-45.2 (OQ®-45.2), developed by Brigham Young University professor Michael Lambert, PhD. Patients complete the 45-question instrumen…
Repairing Ruptures
- Many factors can break down the therapy alliance, such as disagreement on treatment goals, the patient’s misinterpretation of something the therapist has said or a mistrust of the therapeutic process. Research shows that resolving these difficulties, known as therapy ruptures, can lead to better outcomes (Psychotherapy , Vol. 55, No. 4, 2018). Rupt...
Handling Negative Emotions
- Patients probably wouldn’t be in psychotherapy if they didn’t have negative feelings to work through. Unfortunately, it can be difficult for clinicians to have to address patients’ negative states repeatedly. Some therapists become frustrated, which can be taken by patients to mean there’s something wrong with them, says Stony Brook University professor Marvin Goldfried, PhD, co-ed…
Promoting Effective Endings
- When it’s time to end therapy, research by Norcross and colleagues finds that eight actions tend to promote better patient outcomes: having a mutual discussion about how the therapy went, discussing the patient’s future functioning and coping, helping the patient use new skills beyond therapy, framing personal development as an ongoing process, anticipating post-therapy growth…