Therapist competence: its temporal course, temporal stability, and determinants in short-term anxiety-provoking...

Using hierarchical linear models procedures (Bryk & Raudenbush, 1992), growth curve analyses were performed to examine the temporal course, rate of change over time, and determinants of therapist competence in short-term anxiety-provoking psychotherapy (STAPP) (Sifneos, 1992). Treatments were 20 sessions long, were manualized, and therapists were experienced clinicians receiving manual-guided supervision. Patients (N= 13) had mostly anxiety diagnoses. Results indicated that, on average, therapist competence ratings followed a flat-line course over time. Estimated mean rate of change was close to zero and varied very little across therapists. Also, therapists who, in an initial session, were more competent in performing STAPP also intervened more frequently in a helping and protecting manner. One possible implication of the findings is that one initial evaluation may be an unbiased estimator of a therapist's general level of competence across sessions.