Research on psychotherapy has consistently revealed that a portion of the variance in positive outcomes can be explained by therapist variables. Examination of clients preferences for certain therapist characteristics has led to inconsistent results further complicated by differences in participant characteristics. This study on therapist characteristics examines relationships between student-preferred therapist characteristics and demographic information provided by participants in their survey responses. Therapist characteristics under investigation include counseling style and approach to treatment, level of experience and training, and demographic information. This study also validates an online survey as a quality method of investigating university students preferences for therapist characteristics through the use of a one-parameter Rasch Item Response Theory model of analysis. Results from this study suggest that the Web-based survey employed was a quality method of collecting data on student preferences for therapist characteristics. Results also indicate that student prefer a well educated therapist of advanced training who is a good listener, makes them feel comfortable and is nonjudgmental. Finally, results suggest that student preferences for certain therapist characteristics are influenced by student demographic information and previous counseling experiences.

Background: The Good Lives Model (GLM) is a novel strengths-based rehabilitation framework, the principles of which are increasingly being integrated into sexual offender treatment programmes. Previous research has suggested that positive therapist characteristics are empirically associated with treatment change in sexual offender treatment. However, considering the theoretically informed shift from a deficits-based approach to a strengths-based approach in GLM-consistent treatment (GLM-CT), it is reasonable to suggest that therapist characteristics might be reflected differently. Objective: To explore and identify, by expert opinion, what therapist characteristics are important in GLM-consistent treatment and how they might be recognised in a treatment session. Methods: A systematic review of the literature was carried out to appraise the reporting quality of studies that used the Delphi method to develop knowledge on psychotherapeutic models. The empirical study used a three-round Delphi method, a structured consensus-gathering technique, with 28 GLM experts from five different countries. The data in the first round were analysed using content analysis, and data in subsequent round were analysed using descriptive statistics. Results: The systematic review found that the reporting quality in Delphi method studies was respectable in relation to the preparatory stages; however, the reporting quality of aspects of the Delphi methodology important for interpreting the results varied. In regards to the empirical paper, experts endorsed 71 items reflecting the GLM ethos and principles in treatment, listed between twelve categories. Conclusions: The results of the present study suggested that therapeutic characteristics previously identified in sexual offending treatment are indeed important in GLM-consistent treatment. However, additional characteristics were highlighted as important by experts, including emphasis on future-focused and strengths-based language, motivational interviewing skills, flexibility with session material and a good knowledge of clients’ good lives plans. Finally, the results indicated that use of self-disclosure and directiveness in GLM-CT might need to be elucidated in future research.

The present study investigated three pretreatment therapist characteristics (professional burnout, counseling self-efficacy, and gender role orientation) in relation to the therapeutic alliance within the context of youth treatment. It was hypothesized that the emotional exhaustion and depersonalization dimensions of burnout would be negatively associated with the alliance, while the personal accomplishment dimension of burnout and counseling self-efficacy would be positively associated with the alliance. In addition, it was hypothesized that androgynous therapists would have superior alliances, relative to stereotypically masculine or feminine therapists. Participants were 42 pairs of therapists and youth clients. Prior to intake, therapists completed the Maslach Burnout Inventory -- Human Services Survey (MBI), a modified version of the Counselor Self-Efficacy Scale (CSES-M), and the Bem Sex-Role Inventory (BSRI). Clients and therapists completed parallel versions of the Child Therapy Bond Scale (CTBS) following the third session. As hypothesized, results indicated that depersonalization and personal accomplishment were significantly related, in the expected directions, to therapist ratings of the alliance. Other hypotheses were not supported. Future research directions and potential implications of these findings for professional training, service delivery, and quality management in mental health organizations are discussed.

The possibility for a positive treatment result increases when clients decide to stay in their treatment programs. For this to happen the client needs to feel respected and treated with dignity. When the therapist and client are able to build a constructive relationship, a therapeutic alliance will almost certainly follow. This takes work. The purpose of this study was to, thorough the eyes of four therapists, examine to what extent the chosen therapeutic method and/or the personality traits of the therapist creates prerequisites for therapeutic success. Are there shared similarities between different methods of therapy, so called ”Common Factors”, that distinguish themselves as central for creating change?Through qualitative interviews with the therapists working with CBT or Solutionwork and Family systems therapy I found many similarities and some differences. By studying modern research on “Common Factors” and comparing it to the interviews I’ve found several interesting results. Traits like empathy and sensitivity are cornerstones in building the coveted alliance. Change is reached through curiosity, exceptions in behavior and thought but maybe most of all compliments and confirmation. Although it is difficult to define which common factors are of greatest importance this study gives some insight to how therapists with different backgrounds, experience and schooling think about their work and what similarities and differences can be identified in their stories.

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Hintergrund. Für die durch wiederkehrende Essanfälle gekennzeichnete Binge Eating-Störung (BES) wurde die Kognitive Verhaltenstherapie (KVT) als Behandlungsmethode der Wahl etabliert. Zum Psychotherapieprozess, welcher das Therapieergebnis beeinflusst, ist jedoch wenig bekannt. Fragestellung. Da Untersuchungen zum Prozessaspekt der therapeutischen Adhärenz Unterschiede zwischen Patienten eines Therapeuten sowie zwischen verschiedenen Therapeuten belegen, soll der Einfluss von Patienten- und Therapeutenmerkmalen auf die therapeutische Adhärenz geprüft werden. Methode. In einer prospektiven, multizentrischen, randomisiert-kontrollierten Behandlungsstudie zum Wirksamkeitsvergleich von KVT und Internet-basierter angeleiteter Selbsthilfe (INTERBED) wurde die therapeutische Adhärenz in der KVT durch unabhängige Rater erfasst. Patienten- und Therapeutenmerkmale wurden mittels Interview und Selbstbericht erhoben. Ergebnisse. Soziodemografische Merkmale wie ein geringeres Bildungsniveau der Patienten und weibliches Geschlecht der Therapeuten wurden als signifikante Prädiktoren einer höheren therapeutischen Adhärenz identifiziert. Störungsspezifische Merkmale der Patienten waren nicht mit der therapeutischen Adhärenz assoziiert. Therapeutenmerkmale wie ein geringerer Ausbildungsgrad, eine geringere erlebte therapeutische Kompetenz und höhere Erwartungen sowie ein höheres emotionales Wohlbefinden der Therapeuten sagten eine höhere therapeutische Adhärenz vorher. Diskussion. Die etablierte hohe therapeutische Adhärenz erschien unabhängig vom Patienten, während einige Therapeutenmerkmale als Prädiktoren identifiziert wurden. Ungünstige Einflüsse auf die therapeutische Adhärenz bedürfen weiterer Erforschung und einer stärkeren Berücksichtigung in der Ausbildung von Therapeuten. / Background. Cognitive-behavioral therapy (CBT) has been established as the treatment of choice for binge-eating disorder (BED) which is characterized by recurrent binge eating episodes. However, only little is known about the impact of the psychotherapeutic process on treatment outcomes. Objectives. While studies concerning the process aspect of therapist adherence found differences between patients from one therapist as well as differences between therapists, the impact of patient and therapist characteristics on therapist adherence will be investigated. Methods. In a prospective multicenter randomized-controlled trial comparing CBT to Internet-based guided self-help (INTERBED), the therapist adherence to CBT was determined by independent raters. Patient and therapist characteristics were obtained via interview and self-report questionnaires. Results. Sociodemographic characteristics including lower education in patients and female sex in therapists were identified as predictors of higher therapist adherence. Disorder-specific characteristics of patients were not associated with the therapist adherence. Therapist characteristics including less postgraduate therapist training, lower self-rated therapeutic competence, and higher expectations as well as higher emotional well-being of therapists predicted higher therapist adherence. Conclusions. The high level of therapist adherence was mostly independent from patients, while some therapist characteristics were identified as predictors. Adverse impacts on therapist adherence should be investigated further and might be considered in therapeutic training.

While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied. The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance. The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials.

Hintergrund. Für die durch wiederkehrende Essanfälle gekennzeichnete Binge Eating-Störung (BES) wurde die Kognitive Verhaltenstherapie (KVT) als Behandlungsmethode der Wahl etabliert. Zum Psychotherapieprozess, welcher das Therapieergebnis beeinflusst, ist jedoch wenig bekannt. Fragestellung. Da Untersuchungen zum Prozessaspekt der therapeutischen Adhärenz Unterschiede zwischen Patienten eines Therapeuten sowie zwischen verschiedenen Therapeuten belegen, soll der Einfluss von Patienten- und Therapeutenmerkmalen auf die therapeutische Adhärenz geprüft werden. Methode. In einer prospektiven, multizentrischen, randomisiert-kontrollierten Behandlungsstudie zum Wirksamkeitsvergleich von KVT und Internet-basierter angeleiteter Selbsthilfe (INTERBED) wurde die therapeutische Adhärenz in der KVT durch unabhängige Rater erfasst. Patienten- und Therapeutenmerkmale wurden mittels Interview und Selbstbericht erhoben. Ergebnisse. Soziodemografische Merkmale wie ein geringeres Bildungsniveau der Patienten und weibliches Geschlecht der Therapeuten wurden als signifikante Prädiktoren einer höheren therapeutischen Adhärenz identifiziert. Störungsspezifische Merkmale der Patienten waren nicht mit der therapeutischen Adhärenz assoziiert. Therapeutenmerkmale wie ein geringerer Ausbildungsgrad, eine geringere erlebte therapeutische Kompetenz und höhere Erwartungen sowie ein höheres emotionales Wohlbefinden der Therapeuten sagten eine höhere therapeutische Adhärenz vorher. Diskussion. Die etablierte hohe therapeutische Adhärenz erschien unabhängig vom Patienten, während einige Therapeutenmerkmale als Prädiktoren identifiziert wurden. Ungünstige Einflüsse auf die therapeutische Adhärenz bedürfen weiterer Erforschung und einer stärkeren Berücksichtigung in der Ausbildung von Therapeuten. / Background. Cognitive-behavioral therapy (CBT) has been established as the treatment of choice for binge-eating disorder (BED) which is characterized by recurrent binge eating episodes. However, only little is known about the impact of the psychotherapeutic process on treatment outcomes. Objectives. While studies concerning the process aspect of therapist adherence found differences between patients from one therapist as well as differences between therapists, the impact of patient and therapist characteristics on therapist adherence will be investigated. Methods. In a prospective multicenter randomized-controlled trial comparing CBT to Internet-based guided self-help (INTERBED), the therapist adherence to CBT was determined by independent raters. Patient and therapist characteristics were obtained via interview and self-report questionnaires. Results. Sociodemographic characteristics including lower education in patients and female sex in therapists were identified as predictors of higher therapist adherence. Disorder-specific characteristics of patients were not associated with the therapist adherence. Therapist characteristics including less postgraduate therapist training, lower self-rated therapeutic competence, and higher expectations as well as higher emotional well-being of therapists predicted higher therapist adherence. Conclusions. The high level of therapist adherence was mostly independent from patients, while some therapist characteristics were identified as predictors. Adverse impacts on therapist adherence should be investigated further and might be considered in therapeutic training.

While cognitive-behavioral therapy (CBT) is the most well-established treatment for binge-eating disorder (BED), little is known about process factors influencing its outcome. The present study sought to explore the assessment of therapist adherence, its course over treatment, and its associations with patient and therapist characteristics, and the therapeutic alliance. In a prospective multicenter randomized-controlled trial comparing CBT to internet-based guided self-help (INTERBED-study), therapist adherence using the newly developed Adherence Control Form (ACF) was determined by trained raters in randomly selected 418 audio-taped CBT sessions of 89 patients (25% of all sessions). Observer-rated therapeutic alliance, interview-based and self-reported patient and therapist characteristics were assessed. Three-level multilevel modeling was applied. The ACF showed adequate psychometric properties. Therapist adherence was excellent. While significant between-therapist variability in therapist adherence was found, within-therapist variability was non-significant. Patient and therapist characteristics did not predict the therapist adherence. The therapist adherence positively predicted the therapeutic alliance. The ACF demonstrated its utility to assess therapist adherence in CBT for BED. The excellent levels of therapist adherence point to the internal validity of the CBT within the INTERBED-study serving as a prerequisite for empirical comparisons between treatments. Variability between therapists should be addressed in therapist trainings and dissemination trials.