Open Door Review III

"#0!(#0%210B($7!2(($(B&0?!a0D)($2($*D!2!s&2%M!7)*($*0*(t!

I_!H0*%$7#_!S>_!IJ7#0<0_!H>_!Q2*&0<<_!5>!G!HB30%_!O>![+,,b^>!O$0!"#0%210B(0*Y2%$23<0?!$990%!*)7#!0$*! &B*M<0%!I)*($*0*(n!z"#0!(#0%21$6(!Y2%$23<0?!$6!$(!6($<, _!.P_!bPE\->!!! >-001(3! There is broad consensus in the scientific community that the therapist matters. The therapeutic attitude, conceived as the therapist’s personal backdrop against which the therapeutic process is unfolding during treatment, is a salient curative factor. The present study aimed at further elucidating the therapeutic attitude. In order to more subtly differentiate the person of the “healer“, psychoanalysts, psychodynamic psychotherapists, and cognitive-behavioral therapists were investigated. We hypothesized that there are significant differences between therapists of different therapeutic orientations according to their differential training and technique. The Therapeutic Attitude Questionnaire (ThAt), the German translation of the Therapeutic Identity Questionnaire, developed by Sandell and co-workers, was applied to explore the therapist variable. The questionnaire comprises therapists’ demographics, academic and professional training, professional experience, personal therapy or training analysis and therapist’s theoretical orientation. Therapist’s attitude is captured by items of therapist’s belief in curative factors, individual technique and basic assumptions, condensed into the Therapeutic Attitudes Scales (TASC): Adaptation, Insight, Kindness, Neutrality, Supportiveness, Self-doubt, Irrationality, Artistry and Pessimism. Furthermore, therapists described in free-text format their strengths, limitations, aims and difficulties in therapy. We investigated a total sample of 451 psychotherapists: 208 psychoanalysts, 81 psychodynamic psychotherapists and 162 cognitive-behavioral therapists; response rate was 52 %. The central finding of the ANOVA for TASC variables was that adaptation and insight differentiate the groups in the theoretically expected way: cognitive-behavioral therapists believed that the patient’s adaptation to the environment is the most essential curative factor, whereas psychoanalysts believed that insight into problems is the most essential curative factor; psychodynamic psychotherapists took an intermediate stance. CHAID analysis of the TASC variables showed that adaptation contributes the most to the therapists’ differentiation. Thus, we concluded that psychoanalysts, psychodynamic and cognitive-behavioral therapists work in empirically distinguishable ways and as theoretically expected. @)15-1.*$#! This study is limited because it does not address the therapist’s effectiveness as a correlation with the outcome of the therapy is lacking. G$#.1/.\!

Günther Klug, Department for Psychosomatic Medicine and Psychotherapy of the Technische Universität, München, E-mail: Guenther.Klug@lrz.tu-muenchen.de

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