Universität zu Köln

Zarafonitis-Mueller, S., Kuhr, K. and Bechdolf, A. (2014). The Relationship between Therapist's Competence and Adherence to Outcome in Cognitive-Behavioural Therapy - Results of a Metaanalysis. Forschritte Neurol. Psychiatr., 82 (9). S. 502 - 511. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-3522

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Abstract

By now psychotherapy research has provided sufficient evidence in favour of the efficacy of psychotherapy, especially of the cognitive behaviour therapy (CBT). Hence one can argue that psychotherapy truly works. Nevertheless, the rationale for the efficacy and the underlying mechanisms have not yet been explored. Resolving this ambiguity by focusing on the active ingredients in CBT is the aim of our review. More precisely we have explored whether the therapist's competence or his/her adherence to the CBT protocol is responsible for the therapeutic improvement that many patients sustain subsequent to psychotherapy. By means of a broad literature search we identified a total of n=13 studies, whereby n=7 referred to the impact of therapist's competence and n=7 to the impact of adherence on post-treatment outcome, respectively, and one of these studies referred to both. The meta-analytical evaluation yielded a small significant total effect (r=0.24) for the therapist's competence on therapeutic improvement of patients with diverse disorders and a moderate total effect (r=0.38) regarding patients with major depression. In contrast, for the case of an influence of adherence to protocol on post-treatment outcome we did not achieve significant results. Therefore a competent performance of cognitive-behaviour techniques on the part of the therapist seems to contribute thoroughly to the therapeutic improvement subsequent to treatment. However, solely a manual-guided implementation of CBT seems not to have a significant impact on patients impromvement. Furthermore, our results indicate that the therapeutic change constitutes an extensive process that has consequently to be understood in future process-outcome research. Finally the implications of our results as well as potentials for future research are discussed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zarafonitis-Mueller, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bechdolf, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-430126
DOI:	10.1055/s-0034-1366798
Journal or Publication Title:	Forschritte Neurol. Psychiatr.
Volume:	82
Number:	9
Page Range:	S. 502 - 511
Date:	2014
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-3522
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PANIC DISORDER; EFFECT SIZES; PSYCHOTHERAPY; ALLIANCE; DEPRESSION; SCHIZOPHRENIA; EFFICACY; SCALE; INTERVENTIONS; INTEGRITY Multiple languages Clinical Neurology; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43012