An investigation of the relationship between therapist competence and client outcome
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Abstract
This research project was a descriptive study conducted at a clinical psychology practicum center which investigated the relationship between supervisory ratings of student therapist competency and respective client outcome. Cases were assigned to one of four outcome categories on the basis of six outcome criteria. These included: client and therapist assessment of change in presenting complaints and adaptive functioning, client satisfaction with treatment, type of termination, and session attendance. Clinical faculty supervisors completed subjective competency ratings of student-therapists and also rated the difficulty of client cases. A semi-partial correlation was calculated between competency and outcome scores with the effects of case difficulty partialled out of the outcome scores. It was hypothesized that a significant positive semi-partial correlation would emerge.
Forty-eight client cases that were month period were included in the study. seen during a six Also, 14 student therapists belonging to four practicum teams participated.
The major finding of this investigation was that overall, therapist competency ratings were not significantly related to the outcomes of clients, (r=-. 12, p>.05). However, when assessing the relationship between therapist competency and outcome for each of practicum teams individually, a significant negative semi-partial correlation was found for one of them, (r=-1.03, p<.01).
Problems with subjective assessments of competency were discussed and recommendations for improving evaluations were given. Results of a fine grained analysis of outcome data and related variables were presented and discussed as they apply to clinical training and service issues.