The Person of the Therapist

Abstract

Reversing the current primacy in outcome studies of therapy comparisons, this study brings the person of the therapist to the fore. The character of the therapist is a vital component in effective psychotherapy, especially ambitious, relationship-focused, long-term work. Although the person–therapist relationship contributes only 10 to 20% to outcome, identifying beneficial and malign characteristics across therapies is a fruitful area for research, training, and service delivery.

Zusammenfassung

Die Person des Therapeuten

Entgegen dem Trend, bei Studien zu Therapieeffekten verschiedene Therapiearten zu vergleichen, wird in der vorliegenden Arbeit die Person des Therapeuten in den Mittelpunkt gestellt. Der Charakter des Therapeuten ist eine wichtige Komponente für die Therapieeffizienz, besonders unter einer anspruchsvollen beziehungsorientierten Langzeitperspektive. Obwohl die therapeutische Beziehung nur mit 10-20 Prozent der Varianz zum Therapieergebnis beiträgt, ist die Identifizierung sowohl günstiger als auch ungünstiger Charakteristika im Therapievergleich ein fruchtbares Feld für die Forschung, Ausbildung und psychotherapeutische Versorgung.

Résumé

La personne du thérapeute

En reversant la priorité actuelle des études de résultats thérapeutiques sous forme de comparaisons de thérapies, cette étude met la personne du thérapeute en avant. Le caractère du thérapeute est une composante vitale dans une psychothérapie efficace, surtout dans un travail au long terme, ambitieux, focalisé sur la relation. Même si la relation personne-thérapeute ne contribue que pour 10-20% au résultat, l'identification de caractéristiques bénéfiques et malignes à travers les méthodes thérapeutiques constitue un champ fructueux pour la recherche, la formation et l'offre de services.

Resumen

La persona del terapeuta

En oposición a la primacía actual de los estudios sobre resultados de las comparaciones de terapias, este estudio trae al frente a la persona del terapeuta. El carácter del terapeuta es un componente vital, especialmente ambicioso y centrado en la relación, del trabajo psicoterapéutico efectivo a largo plazo. Si bien la relación con la persona del terapeuta contribuye con sólo el 10 o el 20% del resultado, la identificación de características benéficas y perjudiciales a lo largo de las terapias es un área fructífera para la investigación, el entrenamiento y el servicio brindado.

Resumo

A Pessoa do Terapeuta

Este estudo reverte a primazia actual dos estudos centrados nos resultados que comparam terapias ao trazer para o primeiro plano a pessoa do/a terapeuta. As características do/a terapeuta são uma componente vital da psicoterapia eficaz, trabalho especialmente ambicioso, focado na relação e de longo-termo. Embora a relação pessoa – terapeuta contribua apenas entre 10 a 20% para o resultado, identificar estas características benéficas e malignas independentemente da terapia é uma área de frutífera de investigação, treino e prestação de serviços.

Sommario

Sovvertendo l'attuale precedenza negli studi di esito in cui si paragonano diverse terapie, questo studio porta al centro della scena la persona del terapeuta.

Il carattere del terapeuta è una componente vitale in una psicoterapia efficace, specialmente in un lavoro ambizioso, a lungo termine e centrato sulla relazione.

Benché la relazione persona-terapeuta contribuisca solo al 10-20% dell'esito, identificarne caratteristiche benigne e maligne comuni a diverse terapie sembra un'area fruttuosa per ricerca, training e qualità del servizio.

Acknowledgments

While preparing the 2004 Presidential Address on which this article is based, I sought help from Len Horowitz, Sue Wheeler, David Orlinsky, Helge Ronnestadt, Mike Lambert, Anthony Roth, and Peter Fonagy. I thank them for their generous response, fully meeting the excellent tradition of SPR. The interpretation of their contributions is mine.

Notes

1. In contrast to explicit or codified knowledge, tacit knowledge has a personal quality, and is therefore difficult to formalise and codify; it is rooted in action and context. Its acquisition is through experience, apprenticeship and discussion with experienced practitioners.

2. What is significant action is revealed through understanding the patient's assumptive world (Frank, 1973). These acts may be very simple and appear to be insignificant to an uninformed onlooker but both the patient and I know that they have dynamic significance. Once succeeded in, they indicate a yielding of these dynamics. Action may take place within the session or in the patient's ordinary life e.g. a timorous person may assert their view or someone who is insecure in their attachments may, on taking leave of a friend, delay making plans to meet again (Aveline, 1988).