Do therapist experience, diagnosis and functional level predict outcome in short term psychotherapy?
The purpose of this study was to investigate the effects of clinical diagnosis, functional level and therapist experience on the outcome of brief psychotherapy. Patients (N = 123) were clinically diagnosed and assigned to either a psychiatrist, psychiatry resident, family practice resident or medical student. Global Assessment of Functioning (GAF) scores and the Global Severity Index (GSI) of the SCL-90 were rated at baseline, at the end of therapy and at six month follow-up. The Client Satisfaction Questionnaire was also scored after therapy. All groups of patients improved significantly. Neither therapist type and diagnostic category nor their interaction were related to outcome GAF or to GSI. Patients improved irrespective of their baseline symptom severity. Satisfaction with therapy was highly related ot increased functioning and decreased symptom severity. The number of therapy sessions attended by patients was modestly related to outcome and patient satisfaction. The results suggest that many diagnostic groups benefit from brief psychotherapy administered by therapists of varying experience. Furthermore, the results support the practice of having medical students conduct psychotherapy under supervision during their training.
Department of Psychiatry, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec.
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Propst
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Paris
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Rosberger
D000275:Adjustment Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002982:Clinical Clerkship; D002983:Clinical Competence; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005194:Family Practice / Q000193:education; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010348:Patient Care Team; D017060:Patient Satisfaction; D010552:Personality Assessment / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011570:Psychiatry / Q000193:education; D011614:Psychotherapy, Brief / Q000379:methods* / Q000706:statistics & numerical data; D012917:Social Adjustment; D013315:Stress, Psychological / Q000150:complications