Henny A. Westra, of the Department of Psychology at York University in Toronto, recently conducted a study to determine if the skill level and effectiveness of a therapist directly influences the outcome of treatment for a client with generalized anxiety disorder (GAD). Westra said until now, there has been no research demonstrating if the outcome of cognitive behavioral psychotherapy (CBT) is influenced by the effectiveness of the therapist, or if differences between therapists’ education level, clinical experience and personalities, would benefit or impair the overall process for the client.
For their study, the researchers enlisted 32 clients and randomly assigned them to one of four therapists of varying degrees of experience who were rated in order of highest to lowest based on observer-rated CBT competence, client expectations of outcome, client rated treatment and client ratings of the quality of the therapeutic alliance early in treatment. Using the Penn State Worry Questionnaire (PSWQ), the Anxiety Change Expectancy Scale (ACES), Credibility and Expectancy Questionnaire (CEQ), the California Psychotherapy Alliance Scales (CALPAS) and the Cognitive Therapy Scale (CTS), the clients and therapists were rated at several different points throughout eight weeks of treatment for GAD.
The results revealed that overall, the therapist’s competence directly impacted decreases in anxiety for the client. The team found that regardless of what a client expected at the onset of treatment, clients who saw more effective therapists believed they would be able to control their anxiety better than those who saw less effective therapists. Additionally, those same clients reported higher levels of therapeutic alliance. “Clinically, then, it seems important for CBT therapists to attend carefully to the skill with which they structure treatment, their interpersonal effectiveness, and their delivery of specific CBT interventions.” The team added, “Clumsiness, non-responsiveness, or rigidity in these areas might interfere with the promotion of hope and positive expectation, which might in turn disrupt clinically significant change.”
Westra, Henny A., Michael J. Constantino, Hal Arkowitz, and David J.A. Dozois. “Therapist Differences in Cognitive–Behavioral Psychotherapy for Generalized Anxiety Disorder : A Pilot Study.” Psychotherapy 48.3 (2011): 283-92. Print.
© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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