OUTCOME AND PROCESS DIFFERENCES BETWEEN PROFESSIONAL AND NONPROFESSIONAL THERAPISTS IN TIME-LIMITED GROUP-PSYCHOTHERAPY

The outcome of clients who saw one of four ''expert'' professional gro up therapists selected by peer nomination or four ''natural helper'' n onprofessionals nominated by students is contrasted in a 15-session ps ychotherapy group. Process measures tapping specific group and ''commo n factors'' were drawn from sessions 3, 8, and 14; outcome was assesse d at pre-, mid-, posttreatment, and a 6-month follow-up. Results were examined by leader condition (professional vs. nonprofessional therapi sts) and time (group development). Virtually no reliable differences w ere found on measures of outcome primarily because of a floor effect o n several measures. Therapist differences on the process measures tapp ing the ''common factors'' of therapeutic alliance, client expectancy, and perception of therapists were either nonsignificant or disappeare d by the end of treatment. A complex picture of differences on one the rapeutic factor (insight), common factor measures, and subtle variatio n in the outcome data suggests a distinct pattern of change, however. Methodological limitations are also addressed including problems inher ent in large-scale clinical-trial studies, ethical concerns raised by using nonprofessional leaders, and problems with generalizability, giv en the absence of significant psychopathology in group members.