Therapist effects vary significantly across psychological treatment care sectors

Nick Firth; David Saxon; William B. Stiles; Michael Barkham

doi:10.1002/cpp.2461

Therapist Effects in Guided Internet-Delivered CBT for Anxiety Disorders

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246581000069x ◽

2010 ◽

Vol 39 (3) ◽

pp. 311-322 ◽

Cited By ~ 28

Author(s):

Jonas Almlöv ◽

Per Carlbring ◽

Karin Källqvist ◽

Björn Paxling ◽

Pim Cuijpers ◽

...

Keyword(s):

Anxiety Disorders ◽

Statistical Power ◽

Psychological Treatment ◽

Intraclass Correlation ◽

Empirical Support ◽

Behavioural Therapy ◽

Therapist Effects ◽

Cognitive Behavioural ◽

The Individual ◽

The Impact

Background: Guided internet-delivered CBT for anxiety disorders has received increasing empirical support, but little is known regarding the role of the therapist. Aims: This study addressed therapist factors in guided internet-delivered cognitive behavioural therapy for anxiety disorders. Method: Data from three controlled trials with a total N of 119 were analyzed with attention to differences between eight therapists. Results: No significant mean level differences between therapists appeared in the dataset. However, one significant intraclass correlation between participants was found, suggesting that the outcome on the Beck Anxiety Inventory might have been influenced by the impact of the individual therapists. Conclusion: The therapist can possibly have some influence on the outcome of guided internet-delivered CBT for anxiety disorders, but studies with more statistical power are needed to establish whether therapist effects are present in this modality of psychological treatment. The present study was underpowered to detect minor therapist effects.

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Chronic Pain: Fundamental Scientific Considerations, Specifically for Legal Claims

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2013.janfeb01 ◽

2013 ◽

Vol 18 (1) ◽

pp. 1-18 ◽

Cited By ~ 1

Author(s):

Robert J. Barth

Keyword(s):

Health Outcomes ◽

Pain Perception ◽

Driving Forces ◽

Psychological Treatment ◽

Dominant Role ◽

Meta Analysis ◽

General Medicine ◽

Pain Syndrome ◽

Problematic Relationship

Abstract Scientific findings have indicated that psychological and social factors are the driving forces behind most chronic benign pain presentations, especially in a claim context, and are relevant to at least three of the AMA Guides publications: AMA Guides to Evaluation of Disease and Injury Causation, AMA Guides to Work Ability and Return to Work, and AMA Guides to the Evaluation of Permanent Impairment. The author reviews and summarizes studies that have identified the dominant role of financial, psychological, and other non–general medicine factors in patients who report low back pain. For example, one meta-analysis found that compensation results in an increase in pain perception and a reduction in the ability to benefit from medical and psychological treatment. Other studies have found a correlation between the level of compensation and health outcomes (greater compensation is associated with worse outcomes), and legal systems that discourage compensation for pain produce better health outcomes. One study found that, among persons with carpal tunnel syndrome, claimants had worse outcomes than nonclaimants despite receiving more treatment; another examined the problematic relationship between complex regional pain syndrome (CRPS) and compensation and found that cases of CRPS are dominated by legal claims, a disparity that highlights the dominant role of compensation. Workers’ compensation claimants are almost never evaluated for personality disorders or mental illness. The article concludes with recommendations that evaluators can consider in individual cases.

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Are Individuals in Rorschach Nonpatient Samples Truly Psychologically Healthy?

Rorschachiana Journal of the International Society for the Rorschach ◽

10.1027/1192-5604/a000052 ◽

2015 ◽

Vol 36 (2) ◽

pp. 112-155 ◽

Cited By ~ 5

Author(s):

Anna Maria Rosso ◽

Andrea Camoirano ◽

Gabriele Schiaffino

Keyword(s):

Psychological Treatment ◽

Coping Styles ◽

Anxiety And Depression ◽

Future Research ◽

Extensive Form ◽

Community Needs ◽

Rorschach Comprehensive System ◽

Form Quality ◽

And Coping ◽

Rorschach Variables

Abstract. The aim of this study was to collect a Rorschach Comprehensive System (RCS) adult nonpatient sample from Italy using more stringent exclusion criteria and controlling for psychopathology, taking into account the methodological suggestions of Ritzler and Sciara (2008) . The authors hypothesized that: (a) adult nonpatient samples are not truly psychologically healthy, in that a high number of psychopathological symptoms are experienced by participants, particularly anxiety and depression, although they have never been in psychological treatment; (b) significant differences emerge between healthy and nonhealthy groups on Rorschach variables, particularly on CS psychopathological indexes; (c) RCS psychopathological indexes are significantly correlated in the expected direction with scores on psychopathological scales. The results confirmed the hypotheses, indicating the need to collect psychologically healthy samples in addition to normative and nonpatient samples. Because differences were found in the comparison between Exner’s sample (2007) and the healthy group in this study regarding form quality and coping styles, the authors suggest that future research should investigate the construct validity of ambitent style and culturally specific influences on form quality. Moreover, the Rorschach scientific community needs to have more extensive form quality tables, enriched with objects that are currently not included.

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