title: Therapist effects on outcome and alliance in inpatient psychotherapy.
abstract: As an addition to the ongoing discussion concerning the magnitude of therapist effects on outcome in psychotherapy, we investigated therapist variability in a large inpatient psychotherapy sample. We included global symptomatic outcome (Global Severity Index of the Symptom Checklist-90 Revised [SCL-90-R]; German version, Franke, 1995) and alliance (Helping Alliance Questionnaire; German version, Bassler, Potratz & Krauthauser, 1995) ratings of 2554 inpatients who were treated by 50 psychotherapists. Multilevel regression analyses (HLM; Raudenbush, Bryk, Cheong, & Congdon, 2004) were used for analyses. Overall, therapists accounted for a much greater variability on alliance (33%) than on outcome (3%). Therapists were differentially effective with regard to their patients' symptom severity at the beginning of treatment, and therapists differed in the degree that a positive alliance was associated with therapeutic outcome. The relatively small therapist effect on outcome is attributed to compensatory mechanisms in the specific context of inpatient therapy.
authors.affiliation: Department of Psychosomatic and General Clinical Medicine, University of Heidelberg, Heidelberg, Germany. ulrike.dinger@med.uni-heidelberg.de
authors.forename: Ulrike
authors.initials: U
authors.lastname: Dinger
authors.forename: Micha
authors.initials: M
authors.lastname: Strack
authors.forename: Falk
authors.initials: F
authors.lastname: Leichsenring
authors.forename: Fabian
authors.initials: F
authors.lastname: Wilmers
authors.forename: Henning
authors.initials: H
authors.lastname: Schauenburg
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D009497:Neurotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010343:Patient Admission; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory; D011369:Professional-Patient Relations; D011575:Psychoanalytic Therapy; D016896:Treatment Outcome