Kapitel 5

Cooper, M. (2010). Essential Research Findings in Counselling and psychotherapy.London: SAGE

Therapist factors are important because they can have importance for referrals, hiring’s and the therapist’s feeling of self-worth. About 6-9 % of therapeutic outcome depends on therapeutic factors. This is about 0.6 in effect size. The reason for this could be outliers in the project MATCH study.

Improvements and worsening in the practice of different therapist can variate very much, even when they follow a highly manualised procedure. Some indications points to the fact that singe private therapists can do very well or very poorly. In addition some therapist can do best with special clients.

 

Therapists who are psychologically healthy, with a secure attachment style have better outcomes for their clients. Additionally it is important that they know how to act.

Personality: 72% of clients believes that the therapist’s personality is important. The specific traits that are valued has not yet been discovered, however studies show that therapists with a dogmatic or controlled personality get a poorer outcome for their clients.

Attitudes and values: no specific has been pointed out, however the therapist with prejudices have poorer results with the clients that fall within their prejudices. In relation to religion, studies show that it is not the therapist’s values that the clients chose from, but rather whether they think they will be understood and accepted.

 

Sex: studies show that there is no big difference between female and male therapists. However women are assessed to have more direct communication, accurate perceptions and generally more positive attitudes towards clients. No difference between the sex has been found for outcome of therapy for matching, neither compared to non-matched controls, despite the fact that clients often wishes for it.

Sexual orienting: LGB-persons get better results from therapy when they work with a therapist of the same sexual orienting. Studies show that it is particularly in therapy with male therapists, that LBG-clients have difficulties, as the female therapist are more understanding. However matching is not always good, this depends of the problem. The most important is that the client feel understood and accepted.

Age and life-experience: age has little importance for outcome of therapy. However if the therapist is more than 10 years younger than the client this can influence the outcome in a bad way. It is the life-experience of the therapist that is important for outcome, despite the fact that matching in life-experience does not show significant better results than non-matched controls.

Ethnicity: no evidence suggests that the therapists ethnicity can influence the outcome of therapy. Only if the clients experience depression will matching be important for outcome of therapy, despite that many clients wants matching, specially BME-clients (Black and minority ethnics). Training in cultural differences will help get a better outcome of therapy.

Socio-economic status: this has yet to be investigated but Balmforth suggests that it might be a problem that clients has therapists with higher socio-economic status.

Training: there is a significant relation between the therapists training and experience and the client’s outcome of therapy, specially specific training directed at manualised concepts and tasks, skill-specific training gives the best results.

Professional status: comparison between professionals therapists and paraprofessional therapists, studies show that the paraprofessionals, who have best results with long-term therapy and younger clients, get better outcome from therapy. Clients who have been treated by professional trained mental health workers do better than if they have been treated by a GP or an other practitioner from the medical model.

Supervision: studies show that supervision gives better results than non-supervision therapy. The therapist’s work and self-esteem are more secure, especially if supervision is secure, accepting, equal and challenging. In addition many therapists wishes to be directly observed or videotaped.

Professional experience: therapist with more experience have a better outcome from therapy in some studies. However they do not seem to be better at reading the clients, it must be their experience in general clinical contact that are relevant.

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