Predictors and moderators of between-therapists and within-therapist differences in depressed outpatients' experiences of the Rogerian conditions.

ABSTRACT

The extent to which patients experience their therapists as providing empathy, positive regard and genuineness (the Rogerian Conditions) is an important predictor of outcome in the psychotherapy of depression (Zuroff & Blatt, 2006). Using data from 157 depressed outpatients treated by 27 therapists in the cognitive-behavior therapy, interpersonal therapy, or clinical management with placebo conditions of the Treatment of Depression Collaborative Research Program (Elkin et al., 1989), Zuroff, Kelly, Leybman, Blatt, and Wampold (2010) showed that between-therapists and within-therapist differences in Rogerian Conditions at the second treatment session predicted more rapid reductions in overall maladjustment. We conducted novel analyses intended to identify 1) predictors of between-therapists and within-therapist differences in Rogerian Conditions and 2) moderators of the effects on maladjustment of between-therapists and within-therapist differences in Rogerian Conditions. Patients with lower levels of self-critical perfectionism, higher levels of an adaptive form of dependency or higher expectations of warmth from their therapists experienced higher levels of Rogerian Conditions than their therapist's average patient. High baseline self-critical perfectionism diminished the between-therapists effect of Rogerian Conditions on maladjustment, whereas baseline adaptive dependency enhanced the within-therapist effect of Rogerian Conditions. Results shed additional light on the centrality of patient characteristics, the Rogerian Conditions, and their transactions and interactions on outcome in brief outpatient therapy for depression.