EFFECTS OF THERAPIST ADHERENCE AND COMPETENCE ON PATIENT OUTCOME IN BRIEF DYNAMIC THERAPY

The authors examined the relation between therapist process variables( adherence and competence) and subsequent symptomatic change in patient s. Twenty-nine depressed patients were seen in 16 sessions of weekly s upportive expressive (SE) dynamic psychotherapy. Change in depression from intake to Session 3 predicted higher ratings of adherence to expr essive (interpretative) techniques during Session 3 but not their comp etent delivery. Partialling pretreatment psychiatric severity, therapi sts' adherence to use of expressive techniques, and previous symptomat ic improvement, relatively competent delivery of SE-specific expressiv e techniques predicted subsequent improvement in depression. Secondary analyses addressing alternative explanations (such as the role of eit her therapeutic alliance or general therapeutic skills) did not change the results.