Elucidating therapist differences: Therapists’ interpersonal skills and their effect on treatment outcome

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-01-22 DOI:10.1016/j.brat.2025.104689

Brian Schwartz , Miriam I. Hehlmann , Anne-Katharina Deisenhofer , Julian A. Rubel , Lea Fischer , Wolfgang Lutz , Henning Schöttke

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引用次数: 0

Abstract

Objective

Therapists differ in their average treatment outcomes. However, it remains unclear which characteristics differentiate more from less effective therapists. This study examined the association between therapist interpersonal skills and treatment outcome as well as the moderating effect of initial impairment.

Method

Interpersonal skills were assessed with the Therapy-Related Interpersonal Behaviors (TRIB) scale, a group-discussion based rating system, in 99 incoming therapy trainees. The trainees treated n = 1031 outpatients with psychological therapies, whose treatment outcomes were assessed with the Symptom-Checklist 90 Revised (SCL-90-R). Linear mixed models were conducted to predict outcome by therapists’ interpersonal skills beyond initial impairment, number of sessions, therapist age, gender, and theoretical orientation. The moderating effect of initial impairment was calculated as cross-level interaction.

Results

The therapist effect (TE) in this sample was 5.6%. Interpersonal skills were a significant predictor of outcome (b = −0.124, p < .001) and explained 1.3% of variance beyond all control variables. The TE in the final model was VPC = .036 indicating that 26.79% of the TE were attributable to interpersonal skills. The impairment–skills interaction was significant (b = −0.172, p < .001). The effect of interpersonal skills on outcome increased with more severe initial impairment. Results were replicated in a second outcome measure (Outcome Questionnaire 30).

Conclusions

Interpersonal skills were found to be important characteristics to differentiate between more and less effective therapists, especially when treating severely distressed patients. Considering them in therapist selection and matching, outcome prediction, and clinical training could improve the effectiveness of psychological therapies.

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.