The Great Psychotherapy Debate: Models, Methods, and Findings

By Bruce E. Wampold | Go to book overview

8
Therapist Effects:
An Ignored but Critical Factor

The qualities of the therapist that lead to beneficial outcomes has been of interest to psychotherapy researchers and clinicians since the origins of the field. It seems intuitive that some characteristics of therapists would be more desirable than others and that consequently some therapists would be more effective with clients than others. In this regard, therapists are similar to other professionals, as some lawyers win more cases than others, some artists create more memorable and creative sculptures than others, and some teachers facilitate greater student achievement than others.

To understand the many ways that therapists influence the psychotherapy process and outcome, Beutler, Machado, and Neufeld (1994) created a taxonomy of therapist variables, which is presented in Fig. 8.1. They classified aspects related to the therapists as either (a) objective or subjective, and (b) cross-situation traits or therapy-specific states, thereby yielding four types of therapist variables. Many of the therapy-specific states have been discussed in previous chapters. For example, therapist interventions relate to adherence (chap. 7) and specific effects (chap. 5); therapeutic relationships relate to the working alliance (chap. 6); therapeutic philosophy orientation relates to relative efficacy (chap. 4). The cross-situational traits for therapists are characteristics of the therapist that are relatively constant across the various clients treated by the therapist.

Beutler et al. (1994) reviewed the research to identify therapist variables in the four classes that were related to psychotherapy outcome; the preponderance of the evidence was related to therapy-specific states and was con-

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