such clinical issues as the link between insight and action
or to explore how social psychology, cognitive psychology,
developmental psychology and philosophy can enhance
understanding of insight.
At a third and final conference two years later, the group
drafted a chapter on their findings for the APA book “Insight in
Psychotherapy,” published in 2005. Essentially, says Castonguay,
the chapter is a statement by recognized scholars saying, “Here’s
what we agree on and what the future direction of this issue will
Using a similar process, the group held a second series of
Penn State conferences, this time on the topic of corrective
experiences — events that challenge one’s fear or expectations
and lead to new outcomes. “Corrective experiences are only
one part of therapy, but they’re a huge part that often leads to
transformation, making them an important psychotherapy
process to examine,” Hill says.
APA published the resulting book on the conference,
“Transformation in Psychotherapy,” in June.
Characteristics of effective therapists
While the chapters on the therapist effect are still several
years away from being written, the book that will eventually
emerge will include discussion and research that can delineate
personal features distinguishing effective therapists from less
effective ones as well as identify ways of acting in therapy that
trainers, supervisors and therapists themselves can focus on
to help improve the outcome of individual clinicians.
For example, research led by Wampold suggests that effective
therapists have a sophisticated set of interpersonal skills,
including verbal fluency, warmth, acceptance, empathy and an
ability to identify how a patient is feeling. Successful therapists
can also form strong therapeutic alliances with a range of
patients and are able to induce them to accept the treatment
and work with them, he says.
Effective therapists are also highly tuned in to patient
progress, either informally or through the use of outcome
measures, according to research by Michael Lambert,
PhD, a psychology professor at Brigham Young University
and another participant in this latest series of Penn State
conferences. He summarizes his research on the importance
of client feedback in psychotherapy in his 2010 APA book
“Prevention of Treatment Failure.” He says that therapists
must take the time to track patient progress — ideally
through client self-reporting — and take action to address
issues that impede it.
“We know that psychotherapy works — research shows that
a substantial number of people who come to see therapists
will not only benefit from therapy but will also demonstrate
clinically meaningful change,” Castonguay says. Other experts
point out, however, that while therapist factors are clearly
important, they are not exclusive of the models that therapists
practice. It’s imperative that providers make sure the treatments
they are using are based on solid science, says Thomas Sexton,
PhD, a psychology professor at Indiana University and a
member of APA’s Div. 43 (Society for Family Psychology) Task
Force for Evidence-Based Practices.
“There’s evidence to suggest that certain intervention
programs also make a difference with specific client problems,”
Sexton says. “The work of the task force centered around the
position that effective therapists need good interpersonal skills,
a systematic model with good likelihood of success, and the
ability to implement those models with fidelity and clinical
complexity — or with high competence — in ways that match
to the clients.”
And more clients may soon be able to experience meaningful
therapeutic gains if this group can identify the therapist
characteristics and actions that most help — as well as those
that undermine — psychotherapy. n
Amy Novotney is a writer in Chicago.
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Insight in Psychotherapy. Washington, DC: APA.
• Castonguay, L.G., & Hill, C.H. (Eds.). (2012).
Transformation in Psychotherapy: Corrective
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