Recent research from the University of Massachusetts Amherst has discovered that different psychotherapists utilize similar treatment techniques to offer varying advantages to patients.
The findings, published in the Journal of Consulting and Clinical Psychology will eventually lead to more personalized clinical practices and trainings for therapists to help improve their therapeutic effectiveness and improve patient outcomes.
Research has tended not to look at the role of the patient or the treatment type to therapy outcomes. This is understandable in many ways, however the contribution of therapists has been somewhat overlooked. Trainings currently offered that are typically standardised across therapists, don’t promote consistent improvements in the outcomes of patients. We believe that personalizing training to the strengths of each therapist’s individual and weaknesses can improve training outcomes down the line.”
Alice Coyne is the lead author and postdoctoral researcher at Case Western Reserve University. She is also a Ph.D. candidate at UMass Amherst.
Co-author Michael Constantino is a professor of clinical psychology at UMass Amherst and director of the Psychotherapy Research Lab. Coyne did the initial research as part of her Ph.D. dissertation. She received the 2020 Dissertation Award from the Society for the Exploration of Psychotherapy Integration.
Constantino predicts that Constantino’s work will be the first of its kind and will set an example in our field.
The primary goal of her dissertation, Coyne was interested in testing the theory that patients experience greater functional and symptomatic improvement in psychotherapy when a higher-quality therapy-patient relationship is in place, as well as when the patient has a positive expectation of changes.
Coyne was interested in determining whether these associations varied based on the identity of the therapist. Coyne states that a technique may look very different in the hands of a therapist if it is employed by a particular therapist, but not in the hands of someone else if it’s used by another therapist. “One Therapist may use their relationship to their patients as a major way to facilitate improvement. But for another therapist, their relationships could be less important than the use of other strategies, such as fostering a positive expectation for improvement.
Coyne also examined whether certain traits of therapists predict which therapists use relationships and beliefs to provide greater therapeutic advantage across their cases.
To test these questions, the researchers looked at data from 212 adults who were treated by 42 psychotherapists in an experiment that was randomized and compared case-assignment methods in community-based mental health services. Throughout the course of treatment, which varied according to length and type of treatment, patients completed surveys to assess their relationship quality with their therapist as well as their expectations for improvement.
Coyne and Constantino correctly hypothesized that generally, better alliance quality and more positive outcomes are associated with more positive outcomes in treatment. Also, as predicted, therapists showed distinct strengths and weaknesses when it comes to their use of relationship and belief processes.
The paper concludes that preliminary evidence confirms that therapists who make use of the alliance to improve the outcomes of patients are those “… who are more humble when evaluating their own abilities to build alliances.”
One useful takeaway from the research is to Know Yourself. Coyne states, “If you discover the things you are good at as a therapist, then you can tailor and play to your strengths.”
Coyne, A. E., et al. (2021) Therapist-level Moderation of Within- and Between-Therapist Process Outcome Association. Journal of Consulting and Clinical Psychology. doi.org/10.1037/ccp0000676.
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