Therapists, therapist variables, and cognitive-behavioral therapy outcome in a multicenter trial for panic disorder.

Abstract

The relationship between therapists and treatment outcome was examined in 14 highly trained therapists who participated in the Multicenter Collaborative Study for the Treatment of Panic Disorder. Overall, therapists yielded positive outcomes in their caseloads; yet, therapists significantly differed in the magnitude of change among caseloads. Effect sizes for therapist impact on outcome measures varied from 0% to 18%. Overall experience in conducting psychotherapy was related to outcome on some measures, whereas age, gender, gender match, and experience with cognitive-behavioral therapy (CBT) were not. Therapists with above- and below-average outcomes were rated similarly on measures of adherence and competency. The results suggest that therapists make a contribution to outcome in CBT for panic disorder, even when patients are relatively uniform, treatment is structured, and outcome is positive. Implications for future clinical outcome studies and for training clinicians are discussed.

Reliability of Therapist Effects in Practice-Based Psychotherapy Research: A Guide for the Planning of Future Studies

“…Instruments may differ in their ability to capture important variations in outcome and could therefore lead to different TEs. For example, Huppert et al (2001) analyzed data from the Multicenter Collarborative Study for Treatment of Panic Disorder and found TEs ranging from 1% to 18%, depending on the outcome measure in the field of anxiety disorders. Hence, there may be an impact of instruments on TE sizes.…”

Therapist effects and IAPT Psychological Wellbeing Practitioners (PWPs): A multilevel modelling and mixed methods analysis

“…In addition, there is also a range of methodological issues that arise when considering therapist effects. In terms of substantive findings, differences in effectiveness between therapists have been reported in some RCTs (e.g., Huppert, Bufka, Barlow, Gorman, & Shear, 2001), while others have reported small or non-significant effects (e.g., Clark et al, 2006;Wilson, Wilfley, Agras, & Bryson, 2011). These conflicting results are exemplified in two independent analyses of the same data, drawn from the National Institute for Mental Health's Treatment of Depression Collaborative Research Project (NIMH TDCRP; Elkin et al, 1989).…”

Supervision for treatment of depression: An experimental study of the role of therapist gender and anxiety

“…However, any such assumption would be ill-founded, as therapist gender has little consistent impact on therapy performance and patient outcome, with females sometimes performing better than males (Branson, & Shafran, 2015;Huppert, Bufka, Barlow, Gorman, Shear, & Woods, 2001). An alternative explanation is that supervisors might feel that females are more likely to pick up on cues that there are alliance problems, which might stall therapy progression.…”