Michael J Constantino, James F Boswell, Alice E Coyne, Heather J Muir, Averi N Gaines, David R Kraus
{"title":"治疗师对自己基于测量的、针对特定问题的有效性的认知。","authors":"Michael J Constantino, James F Boswell, Alice E Coyne, Heather J Muir, Averi N Gaines, David R Kraus","doi":"10.1037/ccp0000813","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Patient-reported outcomes data reveal differences both in therapists' global effectiveness across their average patient (between-therapist effect) and in treating different problems within their caseload (within-therapist effects). Yet, it is unclear how accurately therapists perceive their own measurement-based, problem-specific effectiveness and whether such self-perceptions predict global between-therapist performance differences. We explored these questions in naturalistic psychotherapy.</p><p><strong>Method: </strong>For 50 therapists, we drew on data from a mean of 27 past patients (total <i>N</i> = 1,363) who completed a multidimensional outcome measure-Treatment Outcome Package (TOP)-at pre- and posttreatment. For each of 12 outcome domains (e.g., depression, anxiety), TOP data classified therapists as historically \"effective,\" \"neutral,\" or \"ineffective.\" Unaware of their data-driven classifications, therapists rated their perceived effectiveness for each domain. We conducted chi-square analyses to determine whether therapists predicted their own measurement-based effectiveness classifications to a level greater than chance. We then used multilevel modeling to test whether therapists' problem-specific perceptions predicted global between-therapist performance differences.</p><p><strong>Results: </strong>For all but one outcome domain, therapists were no better than chance at predicting their measurement-based effectiveness classification. Additionally, controlling for patient baseline impairment, therapists who consistently overestimated their problem-specific effectiveness had patients who reported worse global outcomes than patients whose therapist more accurately estimated their effectiveness. Conversely, therapists who underestimated their problem-specific effectiveness had patients who reported better outcomes than patients whose therapist over- or accurately estimated their effectiveness.</p><p><strong>Conclusions: </strong>Therapist humility may differentiate the most from least globally effective therapists, and this virtue should be cultivated in clinical trainings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":15447,"journal":{"name":"Journal of consulting and clinical psychology","volume":"91 8","pages":"474-484"},"PeriodicalIF":4.5000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Therapist perceptions of their own measurement-based, problem-specific effectiveness.\",\"authors\":\"Michael J Constantino, James F Boswell, Alice E Coyne, Heather J Muir, Averi N Gaines, David R Kraus\",\"doi\":\"10.1037/ccp0000813\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Patient-reported outcomes data reveal differences both in therapists' global effectiveness across their average patient (between-therapist effect) and in treating different problems within their caseload (within-therapist effects). Yet, it is unclear how accurately therapists perceive their own measurement-based, problem-specific effectiveness and whether such self-perceptions predict global between-therapist performance differences. We explored these questions in naturalistic psychotherapy.</p><p><strong>Method: </strong>For 50 therapists, we drew on data from a mean of 27 past patients (total <i>N</i> = 1,363) who completed a multidimensional outcome measure-Treatment Outcome Package (TOP)-at pre- and posttreatment. For each of 12 outcome domains (e.g., depression, anxiety), TOP data classified therapists as historically \\\"effective,\\\" \\\"neutral,\\\" or \\\"ineffective.\\\" Unaware of their data-driven classifications, therapists rated their perceived effectiveness for each domain. We conducted chi-square analyses to determine whether therapists predicted their own measurement-based effectiveness classifications to a level greater than chance. We then used multilevel modeling to test whether therapists' problem-specific perceptions predicted global between-therapist performance differences.</p><p><strong>Results: </strong>For all but one outcome domain, therapists were no better than chance at predicting their measurement-based effectiveness classification. Additionally, controlling for patient baseline impairment, therapists who consistently overestimated their problem-specific effectiveness had patients who reported worse global outcomes than patients whose therapist more accurately estimated their effectiveness. Conversely, therapists who underestimated their problem-specific effectiveness had patients who reported better outcomes than patients whose therapist over- or accurately estimated their effectiveness.</p><p><strong>Conclusions: </strong>Therapist humility may differentiate the most from least globally effective therapists, and this virtue should be cultivated in clinical trainings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>\",\"PeriodicalId\":15447,\"journal\":{\"name\":\"Journal of consulting and clinical psychology\",\"volume\":\"91 8\",\"pages\":\"474-484\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of consulting and clinical psychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1037/ccp0000813\",\"RegionNum\":1,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of consulting and clinical psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/ccp0000813","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
Therapist perceptions of their own measurement-based, problem-specific effectiveness.
Objective: Patient-reported outcomes data reveal differences both in therapists' global effectiveness across their average patient (between-therapist effect) and in treating different problems within their caseload (within-therapist effects). Yet, it is unclear how accurately therapists perceive their own measurement-based, problem-specific effectiveness and whether such self-perceptions predict global between-therapist performance differences. We explored these questions in naturalistic psychotherapy.
Method: For 50 therapists, we drew on data from a mean of 27 past patients (total N = 1,363) who completed a multidimensional outcome measure-Treatment Outcome Package (TOP)-at pre- and posttreatment. For each of 12 outcome domains (e.g., depression, anxiety), TOP data classified therapists as historically "effective," "neutral," or "ineffective." Unaware of their data-driven classifications, therapists rated their perceived effectiveness for each domain. We conducted chi-square analyses to determine whether therapists predicted their own measurement-based effectiveness classifications to a level greater than chance. We then used multilevel modeling to test whether therapists' problem-specific perceptions predicted global between-therapist performance differences.
Results: For all but one outcome domain, therapists were no better than chance at predicting their measurement-based effectiveness classification. Additionally, controlling for patient baseline impairment, therapists who consistently overestimated their problem-specific effectiveness had patients who reported worse global outcomes than patients whose therapist more accurately estimated their effectiveness. Conversely, therapists who underestimated their problem-specific effectiveness had patients who reported better outcomes than patients whose therapist over- or accurately estimated their effectiveness.
Conclusions: Therapist humility may differentiate the most from least globally effective therapists, and this virtue should be cultivated in clinical trainings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
期刊介绍：
The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.
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