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- Sandell, Rolf, et al.
(author)
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Therapist attitudes and patient outcomes : II. Therapist attitudes influence change during treatment
- 2007
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In: Psychotherapy Research. - : Informa UK Limited. - 1050-3307 .- 1468-4381. ; 17:2, s. 201-211
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Journal article (peer-reviewed)abstract
- Psychotherapists' beliefs and attitudes in therapeutic matters, according to the Therapist Attitudes Scales (TASC-2) (Sandell et al., 2004), were related to symptom distress, as measured by the Symptom Checklist-90, in 2 groups of patients: one in ongoing psychoanalytical psychotherapy and the other posttreatment. In the posttreatment group, the zero-order correlations with symptom distress were significant for the therapist's attitudes toward kindness and insight as curative factors and supportiveness as a therapeutic style and his or her views on the nature of psychotherapy as a form of artistry, however, they were all near zero and nonsignificant in the in-treatment group. To account for correlations among the attitude variables, multiple regression analyses were compared between the groups. The multiple correlation was essentially zero in the latter group, whereas there was a significant multiple correlation of .51 in the former group. Thus Posttreatment outcome was significantly related to the therapist's position on the TASC-2 scales. Kindness and Artistry had particularly strong relations with the posttreatment results, with Neutrality acting like a suppressor. The pattern of relations suggested that therapist attitudes functioned as moderators rather than as mediators.
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| 2. |
- Sandell, Rolf, et al.
(author)
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Therapist attitudes and patient outcomes. III. A latent class analysis of therapists
- 2006
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In: Psychology and Psychotherapy. - 1476-0835 .- 2044-8341. ; 79:4, s. 629-647
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Journal article (peer-reviewed)abstract
- Background. Previous research has reported large differences in treatment results between individual therapists practising the same type of psychotherapy, but little is as yet known about the factors explaining this variation. In previous studies the authors have found associations with therapeutic attitudes as measured by the TASC 2 scales. Methods. A sample of 160 therapists were clustered in a non-parametric latent class (LC) regression modelling of their patients' repeated self-ratings on the SCL-90 across stages in psychotherapeutic treatment. This classification was then explored in relation to the therapists' TASC 2 scores. Results. Five classes were identified differing widely in terms of the patients' outcome trajectories. Membership in these classes was significantly influenced by the therapists' scores on the TASC 2 scales. The adjustment, neutrality and artistry scales of the TASC 2 were found specifically discriminative. A discriminant analysis confirmed the findings in general. Collectively, the TASC 2 scales were able to assign 56% of the therapists to their correct latent class, in comparison with 20% by chance. Conclusions. Therapists with a psychoanalytic or eclectic orientation are systematically different in terms of the outcomes they tend to contribute to with their patients. This variation is partly accounted for by differences in their therapeutic attitudes. © 2006 The British Psychological Society.
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| 3. |
- Sandell, Rolf, et al.
(author)
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Therapists' therapies : The relation between training therapy and patient change in long-term psychotherapy and psychoanalysis
- 2006
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In: Psychotherapy Research. - : Informa UK Limited. - 1050-3307 .- 1468-4381. ; 16:3, s. 306-316
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Journal article (peer-reviewed)abstract
- Patients' development across stages in long-term psychodynamic psychotherapy or psychoanalysis was studied in relation to various parameters of their therapists' training, or personal, therapies. The change variable was symptom distress, the General Symptom Index, according to the Symptom Checklist-90. A series of latent class regression analyses revealed that one class of therapists (16% of the sample) whose patients had the least change in treatment, and in fact had nonsignificant deterioration, was significantly overrepresented by psychotherapists with long psychoanalyses for their training therapies. Alternative interpretations of the findings are discussed. © 2006 Society for Psychotherapy Research.
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| 6. |
- Lazar, A., et al.
(author)
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An individual differences perspective on change in psychotherapy : The case of health care utilization
- 2007
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In: Psychotherapy Research. - : Informa UK Limited. - 1050-3307 .- 1468-4381. ; 17:6, s. 690-705
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Journal article (peer-reviewed)abstract
- The purpose of this study was to explore systematic interindividual variation in change of a number of health care utilization variables (HCUVs) during psychotherapy and identify patient characteristics associated with this variation. Three-wave panel data from 420 patients were analyzed with nonparametric latent class regression followed by chi-square interaction analyses among patient variables. For the various HCUVs, three to six classes were identified, with widely different patterns of change during treatment. Axis I diagnosis, chronicity, functional impairment, gender, and level of education were among the patient characteristics that differentiated the classes. It was concluded that main effects analyses seriously distort heterogeneity of change and that health care utilization, unless it is a specific therapeutic aim, may be irrelevant as an indication of outcome of psychotherapy.
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| 7. |
- Lazar, A., et al.
(author)
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Do psychoanalytic treatments have positive effects on health and health care utilization? Further findings of the Stockholm Outcome of Psychotherapy and Psychoanalysis Project (STOPPP)
- 2006
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In: Psychotherapy Research. - : Informa UK Limited. - 1050-3307 .- 1468-4381. ; 16:1, s. 51-66
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Journal article (peer-reviewed)abstract
- Effects of psychoanalytic treatment on subjective health and health care utilization were studied in a sample of 420 patients in various stages of psychotherapeutic treatment. Outcome measures, based on a self-report questionnaire taken for three consecutive years, included the Self-Rated Health Scale (SRH), General Symptom Index (GSI) from the Symptom Checklist-90 (SCL-90), and Sense of Coherence Scale (SOCS) as well as self-reports on health care utilization during the past 12 months. The study had a quasi-experimental, accelerated longitudinal design. Individual raw scores of the dependent variables were regressed, one by one, on an eight-step treatment stage scale. Sex, age, and education level were entered in a first block to partial out their possible effects. In contrast to the significant positive developments found on the subjective health measures (SRH, GSI, and SOCS), no significant change was found on the health care utilization variables. The complications in interpreting psychotherapy effects on health and health care utilization are discussed. © 2006 Society for Psychotherapy Research.
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| 8. |
- Lazar, A., et al.
(author)
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Subjective health and ill health-related behaviour
- 2007
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In: Psychology and Psychotherapy. - 1476-0835 .- 2044-8341. ; 80:2, s. 297-309
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Journal article (peer-reviewed)abstract
- Objective. The aim of this study was to investigate the relation between self-rated health measures and ill healthrelated behaviour. Design. The study design was based on a self-report questionnaire taken for three consecutive years. Method. Path analysis was used to test the relations between (a) The Self-rated Health Scale (SRH) and the General Symptom Index (GSI) from the Symptom Checklist-90 (SCL-90), and (b) self-reports on sick leave, health care utilization and medication, in a group of 155 persons who had terminated psychotherapeutic treatment the year before our three-year panel survey. To investigate the potential moderating function of ongoing psychotherapeutic treatment, we repeated each test in a group of 152 patients in the midst of psychotherapeutic treatment. Results. Only weak or zero relations were found between the self-rated health measures and ill health-related behaviour. The multi-group analyses indicated between-group differences in model fit. The few significant specific between-group differences all concerned autoregressive relations. Conclusions. Subjective health did not predict ill health-related behaviour. Ongoing psychotherapeutic treatment did not affect the predictive value of subjective health variables. The weak relations found in the current study illuminate paradoxical outcome differences between subjective well-being and ill health-related behaviour. Our findings are discussed in the light of cultural and personality factors. © 2007 The British Psychological Society.
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