The study may lead to more personalized clinical practices and training for psychotherapists
New research at the University of Massachusetts at Amherst shows that different psychotherapists use common treatment processes with varying benefits for patients.
The findings, published in the Journal of Consulting and Clinical Psychology, may ultimately lead to more personalized clinical practices and training for therapists to maximize their therapeutic impact and improve patient outcomes.
Research has tended to focus on patient or type of treatment contributions to therapy outcomes, which makes sense in many ways, but unfortunately the therapist’s contribution has been somewhat overlooked. Our current trainings, which are often standardized across therapists, tend not to promote consistent improvements in patient outcomes. Instead, we believe that tailoring training based on the unique strengths and weaknesses of therapists could improve training outcomes across the board. “
Alice Coyne, senior author, post-doctoral researcher at Case Western Reserve University and PhD. graduate of UMass Amherst
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 his doctorate. thesis, which received the 2020 thesis award from the Society for the Exploration of Psychotherapy Integration.
“His work is the first of its kind and it will pave the way in our field,” predicts Constantino.
As a first goal of his thesis, Coyne was interested in testing the prediction that patients experience more symptomatic and functional improvement in psychotherapy when a better patient-therapist alliance exists, as well as when the patient has a more positive expectation. of change.
For the second objective, Coyne was interested in seeing if these associations differed depending on the identity of the therapist. “A technique given in the hands of one therapist may look very different from the same technique in the hands of another therapist,” Coyne explains. “To put it simply, a 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 the improvement of the patient than the use of other strategies, such as positive culture change expectations. “
Finally, for the third objective, Coyne examined whether certain characteristics of therapists predict which therapists tend to use relationship and belief processes for greater therapeutic benefit across their workload.
To test these questions, the researchers analyzed data from 212 adults who were treated by 42 psychotherapists in a randomized trial comparing case allocation methods in community mental health care. Throughout the treatment, which varied in length and type, patients repeatedly completed surveys measuring the quality of their alliance with the therapist and their expectations for improvement.
Coyne and Constantino correctly hypothesized that in general, better alliance quality and more positive outcome expectations are associated with better treatment outcomes. Additionally, as expected, therapists exhibited different strengths and weaknesses in their use of relationship and belief processes.
Finally, there was preliminary support that the therapists who have used the alliance most effectively to promote patient improvement are those “… who are more humble in assessing their own abilities to foster the alliance.” , states the article.
Know Yourself Humbly can be a useful takeaway from research. “If you learn the things that you do particularly well as a therapist, then you can adapt your practice and play to your strengths,” Coyne explains.
University of Massachusetts Amherst
Coyne, AE, et al. (2021) Moderation at the level of the therapist of the intra and inter-therapist process-result association. Journal of Consulting and Clinical Psychology. doi.org/10.1037/ccp0000676.