When it comes to client recovery, it’s not the type of therapy that matters so much as the individual therapist who’s giving it – that’s the message from a study by researchers at Brigham Young and Ohio universities in America.
John Okiishi and a team of colleagues examined real-life data from 1,841 student clients with problems ranging from homesickness to personality disorder, who between them saw 56 therapists at a large university counselling centre. Before each therapy session, clients completed an outcome questionnaire designed to track their progress and recovery.
The researchers found no effect of therapists’ sex, level/type of training, or their theoretical orientation (cognitive behavioural, humanistic or psychodynamic) on clients’ recovery. There were, however, massive differences between therapists in the typical outcome of their clients and the duration of therapy. A client seeing one of the top three therapists(on average) could expect to feel dramatically better after a few weeks treatment. By contrast, a client seen by one of the bottom three therapists could expect, on average, to feel the same, possibly worse, after three times as much treatment. The range of severity of clients’ problems at treatment onset was similar for the different therapists.
The authors concluded “something about these (more successful) therapists and the way they work, independent of the amount of time spent with clients, has a significant impact. . . There is an urgent need to take account of the effectiveness of the individual therapist and it is time for clinicians to welcome such research”.
Okishi, J., Lambert, M.J., Nielsen, S.L. & Ogles, B.M. (2003). Waiting for supershrink: an empirical analysis of therapist effects. Clinical Psychology and Psychotherapy, 10, 361-373.