Psykoterapeutin henkilökohtaisten ominaisuuksien merkitys psykoterapiassa ja niiden vaikutus tuloksellisuuteen identiteettihaastattelun perusteella

Abstract

The purpose of my study was to use the Psychotherapist Identity Interview (PII) method, developed for this study and based on Erik H. Erikson's and Heinz Kohut's theories, to examine the significance of the personal characteristics of psychotherapists for psychotherapy, and their effect on treatment results. The study described the theoretical background and development of the interview method and the validation of the instrument. The study involved 68 contract therapists from the Helsinki Psychotherapy Study and 333 patients, of whom 65 therapists and 308 patients were included in the as-sessment of benefit from therapy. Videotaped, semistructured therapist interviews were assessed using 16 variables describing therapists and based on Erikson's and Kohut's theories. Three factors, Creative will, Empathy, and Ability to form close interpersonal relationships, were formed from the variables and examined in relation to demographic and therapist factors. Solution-focused therapists had more slightly pronounced Creative will than advanced specialist level and specialist level psychodynamic therapists. Therapists delivering solution-focused therapy had more pronounced Creative will compared to other therapists. Therapists delivering solution- focused therapy had less Empathy than other therapists. Therapists living alone with one or more minor children had less Ability to form close interpersonal relationships than those living with a spouse or with a spouse and one or more minor children. Cluster analysis provided six clusters described qualitatively on the basis of the researcher's description of the atmosphere in the interview situation. The clusters were assessed in relation to the benefit from therapy at 12 months as assessed by outside interviewers. Based on paired comparison of the clusters only the fifth cluster (Dependence-tinged warmth and calm unhurriedness, scant awkward feelings) differed from all others. The patients' benefit from therapy delivered by therapists of that cluster was clearly less than in the case of the other clusters. According to assessment by external interviewers at 12 months, patients of therapists administering long-term psychodynamic psychotherapy had benefited from therapy more, on average, than patients whose therapists did not administer long-term psychodynamic psychotherapy. The difference between the benefit obtained by the patients of therapists providing long-term psychodynamic psychotherapy and the patients of therapists not providing that therapy was independent of the therapists' characteristics.