治疗师的影响比我们想象的更重要吗?

IF 1.5 Q3 PSYCHOLOGY, CLINICAL JOURNAL OF CONTEMPORARY PSYCHOTHERAPY Pub Date : 2024-07-26 DOI:10.1007/s10879-024-09641-x
Refael Yonatan-Leus, Rena Cooper-Kazaz
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引用次数: 0

摘要

常规心理治疗结果研究的主要局限性之一是缺乏对治疗条件的随机分配,因此无法进行因果推论。同时,治疗师效应和经验支持的治疗关系已被证明非常重要,甚至比治疗类型更具影响力。在这项理论研究中,我们建议使用治疗师效应估计(指不同治疗师在改善患者疗效方面的系统性差异)来缓解这一局限性。我们深入阐述了将不同治疗师的治疗视为不同治疗条件的理论依据,同时提到了在个体样本层面研究治疗师效应估计的实用方法。当前的研究表明,在实地研究中,治疗师所获得结果的差异有可能近似地反映出治疗与结果之间的因果关系。有鉴于此,我们建议在可能的情况下,在每项心理治疗研究中都对治疗师效应进行显著性检验,并提倡在治疗师的个人发展方面投入资源,在决策中为临床经验留有余地。
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Are Therapist Effects More Crucial than We Thought?

One of the main limitations of routine outcomes psychotherapy studies is the lack of random assignment to treatment conditions, which precludes causal inference. At the same time, therapist effects and empirically supported therapy relationships have proven to be important and even more influential than the type of treatment. In this theoretical study, we propose using therapist effects estimation, which refers to the systematic differences in the effectiveness of improving patient outcomes between therapists, to mitigate this limitation. The theoretical rationale for treating different therapists’ treatments as different treatment conditions is presented in depth while referring to practical methods of examining therapist effects estimation at the individual sample level. The current study demonstrates how variation in the results obtained by therapists in field studies holds the potential to approximate a causal relationship between therapy and outcomes. In light of this, we recommend performing significance testing for the therapist effect in every psychotherapy study where this is possible, as well as advocating investing resources in the personal development of the therapist and giving room for clinical experience in decision-making.

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来源期刊
CiteScore
4.40
自引率
5.00%
发文量
44
期刊介绍: Journal of Contemporary Psychotherapy provides an international forum to critique the complexities and controversies facing psychotherapists. The journal publishes original peer-reviewed articles that critically analyze theory, research, or clinical practice. Empirical studies, panel discussions, essays, case studies, brief reports, and theoretical articles are published. Psychotherapists and clinical researchers will find this journal an important vehicle to review the problems of treating a variety of patients.
期刊最新文献
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