Which therapist-related factors influence the therapeutic process? - Chapter 5

Research by Ricks (1974) shows that two therapists, both working with severely disturbed male adolescents, can achieve strikingly different results. More recent research with larger samples confirms this result. About nine percent of the variance in psychotherapeutic outcome is due to variations in individual therapists. Research shows that ratios of positive and negative results differ considerably between therapists. This is true, even when the different therapists use the same set of controlled protocols.

What characteristics predict the outcome of therapy?

A small significant positive relationship has been found between the therapist's well-being and the outcome of the therapy for the client.

Research shows that the therapist's personality is one of the most important factors of the therapy for the client. However, there is no clear evidence for correlations between client outcomes and therapist personality traits. Some evidence has been found that therapists with unconscious dogmatic and controlling ideas and attitudes ('introjects') have worse therapy outcomes.

Research shows that there is no direct relationship between the beliefs or values ​​of the therapist and the results of the client. However, it has been found that clients with strong and / or extreme values ​​or beliefs prefer therapists with corresponding values ​​or beliefs because they feel better understood.

What else does the outcome of the therapy depend on?

Not much evidence has been found for differences between male and female therapists when it comes to premature quitting or improving clients. However, some evidence has been found which show that clients of female psychotherapists are, on average, more satisfied with their therapy. Recent research shows that clients who are linked to a same-sex therapist are more satisfied with the therapy and follow the therapy for a longer time.

Clients of marginalized social groups (for example, with a less common sexual preference) show a preference for therapists from similar groups. This can lead to positive outcomes for the client, but often the therapist's attitudes and beliefs are more important.

There does not seem to be a relationship between the age and personal experiences of the therapist and the outcome of the client.

Professional development through training, supervision and especially experience are related to some degree to therapeutic outcomes. However, the effect size is small and paraprofessionals seem to achieve as good results as professionals.

Conclusion

In general, the therapist's traits seem to be a less important predictor of therapeutic outcomes compared to the way therapists relate to their clients.

Chapter questions

1. What causes the variance in psychotherapeutic results?

2. What role does the therapist's personality play?

3. Why do clients with strong beliefs prefer therapists with similar beliefs?

4. How can the relationship between the age and personal experiences of the therapist and the outcome of the client be described?

5. To what extent do the characteristics of the therapist and the way in which he or she relates to the client predict the therapeutic results?