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Although studies have shown that client feedback can improve treatment outcome, little is known about which factors might possibly moderate the effects of such feedback. The present study investigated potential therapist variables that might influence whether frequent client feedback is effective, including the Big Five personality traits, internal/external feedback propensity and self‐efficacy. Data from two previous studies, a quasi‐experimental study and a randomized controlled trial, were combined. The sample consisted of 38 therapists and 843 clients (55.4% females, mean age = 42.05 years, SD = 11.75) from an outpatient mental health institution. The control condition consisted of cognitive‐behavioural therapies combined with low frequency monitoring of clients' symptoms. In the experimental condition, high‐intensity (i.e., frequent) client feedback as an add‐on to treatment as usual was provided. Outcomes were measured as adjusted post‐treatment symptom severity on the Symptom Checklist‐90 and drop out from treatment. The final model of the multilevel analyses showed that therapists with higher levels of self‐efficacy had poorer treatment outcomes, but when high‐intensity client feedback was provided, their effectiveness improved. Furthermore, higher self‐efficacy was associated with a higher estimation of therapists' own effectiveness, but therapists' self‐assessment of effectiveness was not correlated with their actual effectiveness. The results of this study might indicate that therapists with high levels of self‐efficacy benefit from client feedback because it can correct their biases. However, for therapists with low self‐efficacy, client feedback might be less beneficial, possibly because it can make them more insecure. These hypotheses need to be investigated in future research. [ABSTRACT FROM AUTHOR]

Objective. The Psychological Mindedness Assessment Procedure [PMAP; McCallum, M. & Piper, W. E. (1990)] operationalizes psychological mindedness as a participant's understanding of the problem presented by two videotaped enacted patients. To possibly enhance predictive power for psychotherapy outcome, we added two video scenarios with emotionally high-impact. This article describes psychometric properties of the Dutch translation of the PMAP and the extended version, the PMAP-plus. Design. A therapy-analogue study with non-clinical participants (N = 100). Methods. In individual sessions, participants watched the four video-scenarios and responded to the PMAP-question 'What seems to be troubling this woman?'. Emotional reactions were measured using the Positive And Negative Affect Schedule [PANAS; Watson, D., Clark. L. E. & Tellegen, A. (1988)]. Results. The PMAP and the PMAP-plus had good interrater reliability. As expected, PMAP-levels were lower for the newly added high-emotional scenarios. Validity was further supported by a negative relation of PMAP-scores with the Negative Affect subscale. Conclusions. The Dutch translation of the PMAP and the added scenarios of the PMAP-plus are reliable instruments. The predictive power for psychotherapy outcome needs to be investigated in a patient group. The variation in presented clinical problems could also make it a useful instrument to assess psychological mindedness in psychotherapists. [ABSTRACT FROM AUTHOR]

This article describes a qualitative study of 63 difficult therapeutic situations described by 26 therapists. The study was part of research on specific reactions of therapists to traumatized clients. The research questions for the current analyses focused on the categorization of difficult situations, of short-term therapist reactions, and the exploration of situat ion-specific reaction patterns. The therapeutic style of the therapist was also explored. Three types of difficult situations were found: 'traumatic situations', 'interactional situations' and 'existential situations'. Therapist reactions were sorted into 20 categories; 10 of them were part of a situation-specific pattern. The therapeutic style of therapists was defined by a first dimension reflecting a continuum of experiencing versus actively intervening and a second dimension of feeling responsible. The r elevance for therapist self-reflection, supervision and training is to acknowledge the specific difficulties in different therapeutic situations related to therapist-specific reactions, and to enhance constructive coping in accordance with the therapist's therapeutic style. [ABSTRACT FROM AUTHOR]