Objective The aim of this study was to review the literature on clinician characteristics influencing patient–clinician communication or patient outcome in oncology. Methods Studies investigating the association of clinician characteristics with quality of communication and with outcome for adult cancer patients were systematically searched in MEDLINE, PSYINFO, PUBMED, EMBASE, CINHAL, Web of Science and The Cochrane Library up to November 2012. We used the preferred reporting items for systematic reviews and meta‐analyses statement to guide our review. Articles were extracted independently by two of the authors using predefined criteria. Results Twenty seven articles met the inclusion criteria. Clinician characteristics included a variety of sociodemographic, relational, and personal characteristics. A positive impact on quality of communication and/or patient outcome was reported for communication skills training, an external locus of control, empathy, a socioemotional approach, shared decision‐making style, higher anxiety, and defensiveness. A negative impact was reported for increased level of fatigue and burnout and expression of worry. Professional experience of clinicians was not related to communication and/or to patient outcome, and divergent results were reported for clinician gender, age, stress, posture, and confidence or self‐efficacy. Conclusions Various clinician characteristics have different effects on quality of communication and/or patient outcome. Research is needed to investigate the pathways leading to effective communication between clinicians and patients. Copyright © 2013 John Wiley & Sons, Ltd.

A variation of task analysis was used to build an empirical model of how therapists may facilitate client assimilation process, described in the Assimilation of Problematic Experiences Scale. A rational model was specified and considered in light of an analysis of therapist in-session performances (N = 117) drawn from six inpatient therapies for depression. The therapist interventions were measured by the Comprehensive Psychotherapeutic Interventions Rating Scale. Consistent with the rational model, confronting interventions were particularly useful in helping clients elaborate insight. However, rather than there being a small number of progress-related interventions at lower levels of assimilation, therapists' use of interventions was broader than hypothesized and drew from a wide range of therapeutic approaches. Concerning the higher levels of assimilation, there was insufficient data to allow an analysis of the therapist's progress-related interventions.

Objectives: The Assimilation of Problematic Experiences Scale (APES) describes eight levels that a problematic experience passes through en route to becoming part of the person's self. Theoretically, progress along this continuum may be facilitated by therapist interventions that are appropriately responsive to the problem's current APES level, in the sense that they help the patient move from the current level to the next. This study aimed to investigate links between therapist intervention choice and progress across APES levels. Design: A theory‐building case study was undertaken to assess and revise hypotheses concerning which therapeutic interventions are optimally responsive at each APES level. Method: Therapeutic interventions, measured by the Comprehensive Psychotherapeutic Interventions Rating Scale and assimilation level, measured by the APES, were assessed in 34 session transcripts of a 30‐year old woman treated with brief psychodynamic therapy for bouts of weeping and diffuse anxiety. Results and conclusion: Results were promising and enabled us to adjust our hypotheses, expanding and elaborating the Assimilation Model. Implications for practice: Our case study showed how specific therapist interventions may facilitate assimilation and underlined the dialogical dimension of the therapy process.

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The assimilation of problematic experiences as operationalization of internal multiplicity has been studied as change processes in psychotherapies of different client populations. However, there is little research investigating the assimilation processes with a particular focus on clients with borderline personality disorder (BPD), as they engage in treatment. Internal multiplicity describes the presence, within the person, of different centers of experience, called inner "voices". These may result from unresolved traumatic experiences associated with BPD. The current study is a theory-building case study, which aims at understanding the evolution of internal multiplicity in a short-term treatment over 10 sessions for a client with BPD, aiming at engagement in long-term treatment. The case, Louise, presents with a high potential of internal conflicts, showing four antagonistic problematic voices. The intensive assimilation analysis of these voices, with regard to the dominant voice, suggests that their assimilative change tends to pass from chaotic multi-voice cacophony to a structuring twovoice dialogue (i.e., a mutual elaboration of the conflicts). Our results underline that internal dialogue between previously opposed voices may be a productive way for clients with BPD to evolve in therapy and use their internal multiplicity as a resource. Narrative details and illustrations are presented to document Louise's change processes over her process of engagement in therapy.