Therapist Training and Client Characteristics as Predictors of Treatment Response to Group Therapy for Depression

Abstract

Although psychotherapists routinely make decisions about how to match treatment to a particular client, these decisions are typically guided by something other than empirical knowledge. Two variables that have shown promise in matching treatments to clients are psychological reactance and externalizing coping styles. The current study explored the relationship of these 2 client characteristics to response to 2 types of group therapies for depression-group cognitive-behavioral therapy and mutual support group therapy-led by 2 types of leaders: professionally trained and paraprofessional. Hypotheses regarding interactions of client characteristics and treatment type were not supported. However, an interaction of therapist training level with clients' coping style emerged, indicating that, regardless of the type of treatment provided, clients with a more externalizing coping style fared better when treated by paraprofessionals than by professionals, whereas those with a more internalizing coping style gained more from treatment with professionally trained therapists than paraprofessionals. These results suggest that attention must be given to therapist characteristics if research is to contribute to a model of systematic treatment selection.