The Importance of Therapists

Sergiu Vidican

Written by Sergiu Vidican on July 9th 2010
Posted in: Featured, Science
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A recent study has revealed the fact that the people who suffer from severe depression improve much faster when the therapists follow the principles for delivering the cognitive therapy. It has also been revealed that the competence of the therapist is extremely important. The competence itself can change the outcome of the patient’s health. The study revealed that the competence of the therapist was important and influential only in certain cases; more precisely in the case of the people who suffered from depression and anxiety, and in the persons who suffered from depression since an early age.

Daniel Strunk, co-author of the study and assistant professor of psychology at Ohio State University, said that the people who are depressed but who do not suffer from anxiety have high chances of improving their condition even if they do not see the best therapists in the domain. The treatment which works for these people is effective in most of the cases, no matter who the doctor is. The most important thing for them is to go and see a therapist, as fast as they can because if left untreated depression can become a much more serious health problem. He believes that the people who have suffered from depression since an early age are the ones who should look for the best therapists in the domain. The persons who suffer from severe cases of anxiety besides depression should do the same thing.

It is obvious that everyone would like to be treated by the best doctors, and that they have the highest faith in them. However, Strunk mentioned that an investigation hasn’t been made in the domain so far. It is unknown if the people who suffer from severe depression get better because their doctor is very good or if they would have gotten the same results from another doctor. The studies usually rate the competitiveness of the doctors and the outcome of the patients. If the patients get well and the doctors have high ratings, people automatically assume that the doctors are responsible for the improvement of the patient. Strunk mentioned that that is not particularly correct since no one has analyzed the role of the therapist’s competence when it comes to curing a patient. According to him, the competence of the doctors is given by the outcome of the evolution of the patient, even if in reality the doctor might not be that great.

If a patient gets better, people automatically believe that the doctor is a very competent one, even if he wasn’t that influential over the course of the progression. Strunk said that he wanted to see if the competence influenced the outcome of the patients every time, or if the outcome of the patients is influenced by other factors. Two researchers examined videotapes of therapy sessions which were done by six doctors on 60 patients. The patients suffered from moderate to severe depression. The researchers used the Cognitive Therapy Scale in order to rate the competence of the doctors. The same scale is used in the case of the cognitive therapists. Various skills of the patients are tested through the examination, from interpersonal relations to the use of certain techniques which would help the patients to recover from depression much easier. The researchers used the first four sessions in order to rate the competence of the therapists. All the 60 patients were involved in these sessions, and that gave the researchers the possibility to observe the way in which the therapists tried to cure various stages of depression.

The patients were asked after the end of each session to complete a questionnaire, and in it they had to answer questions which would indicate their depression levels.  Strunk and his team then compared the grades which were given to the therapists after each session with the questionnaires which indicated the depression levels of the patients. They wanted to see if there is a relationship between the grades and the improvement of the patients. The researchers had no idea about the results of the questionnaires when they rated the therapists. This means that the grades which they gave to the therapists were not influenced by the patients. Only after they saw the questionnaires they were able to see if there was a relationship between the competence of the therapists and the improvement of the patients.

The strongest results came when the researchers analyzed the improvement of patients with various illnesses and compared them with the competence of the therapists who worked with them. The researchers said that most competitive therapists were the ones who made the biggest difference when it came to the patients who suffered from early depression and the ones who had high anxiety levels. The researchers also analyzed the improvement of the patients from one session to the other. They realized that the patients who improved the most during these four sessions were the ones who were helped by the highest rated therapists. The researchers also analyzed the improvement of the patients after 16 weeks, and they observed that the competitiveness of the therapists influences the improvement of the patients on the long run, but does not have such importance as the short-term therapy.  Strunk believes that the reason for this is that the therapists might not have the same success on every session and because of that, their competence seems to diminish on the long run.

Strunk said that if that is the reason for the decrease in effectiveness, then the method of analyzing the competence of the therapists is not good enough, and that they need to look for other methods of analyzing it. Even the best therapists might do poorly on some of the sessions, and this is why their ratings are not constant at all times. Strunk mentioned that based on their results, the clinic directors should choose certain therapists for certain patients, by looking at their characteristics. He said that the best therapists should receive the patients with the most severe depression and anxisety.

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