[Individual therapists in inpatient psychotherapy -- a pilot study on their importance for therapeutic outcome]

How much does the individual psychotherapist influence therapy outcome in a multimodal inpatient setting with several therapeutic relationships and the additional influence of group processes.

We studied the outcome of n = 293 psychotherapy inpatients (mean treatment duration: 11 weeks) who were treated in an integrated inpatient concept by 9 mostly psychodynamically oriented psychotherapists (professional experience 0.5 to 7 yrs, 13 to 56 patients per therapist). Patients had an extensive evaluation of process and outcome variables (e. g. SCL 90R, IIP, Global outcome rating, Helping Alliance Questionnaire - HAQ). Differences in outcome between patients of different therapists were calculated.

Patients assigned to the participating therapists did not differ in their basic clinical characteristics, except in the clinical severity rating carried out by therapists themselves. Outcome in the SCL90R - GSI residual score and global rating differed significantly between the therapists (d (SCL-pooled SD) = 0.43 to 1.10, explained variance: 10 %). The same holds true for the therapeutic alliance (HAQ, explained variance: 45 %). Assessment of therapeutic relationship shows good correlation between patients and therapists, outcome assessment does not. Therapists differed in the degree of matching between their own and their patients' evaluations.

We found significant therapist differences in outcome and alliance. Despite the multifaceted inpatient setting the individual therapist is an important determinant of therapeutic success.