Personal Skills and The Therapist Effect on The Initial Symptomatic Change in Psychotherapy

Abstract

Therapist effect is his or her contribution on the outcome of psychotherapy compared to the outcome of another therapist. Supposedly, empathy is a key element in therapeutic change. Aim: to examine therapist effect as well as empathy in relation to initial symptomatic change in treatment. Method: Initial sample comprised 41 therapist and 185 adult patients attended in psychoanalytic therapy. Therapists completed questionnaires about the facets of empathy and patients repeatedly responded to an outcome measure. Intraclass Correlation Coefficient was used to measure therapist effect and Multilevel Hierarchical Regression was used to assess empathy facets effects on treatment initial outcome. Calculations excluded therapists with less than five patients and were performed on a subsample of 16 therapists and 177 patients. Results: Therapist effect was 9,6%. The only empathy facet related to psychotherapy outcome was Fantasy, with a general effect of 0,71%. Conclusion: Although therapist empathy is supposed to be crucial to outcomes, little is known about this interaction. Fantasy seems to play an important role in this context, providing identification of the therapist with the patient. Further studies are needed.