OBJECTIVE Patient-reported outcomes data reveal differences both in therapists' global effectiveness across their average patient (between-therapist effect) and in treating different problems within their caseload (within-therapist effects). Yet, it is unclear how accurately therapists perceive their own measurement-based, problem-specific effectiveness and whether such self-perceptions predict global between-therapist performance differences. We explored these questions in naturalistic psychotherapy. METHOD For 50 therapists, we drew on data from a mean of 27 past patients (total N = 1,363) who completed a multidimensional outcome measure-Treatment Outcome Package (TOP)-at pre- and posttreatment. For each of 12 outcome domains (e.g., depression, anxiety), TOP data classified therapists as historically "effective," "neutral," or "ineffective." Unaware of their data-driven classifications, therapists rated their perceived effectiveness for each domain. We conducted chi-square analyses to determine whether therapists predicted their own measurement-based effectiveness classifications to a level greater than chance. We then used multilevel modeling to test whether therapists' problem-specific perceptions predicted global between-therapist performance differences. RESULTS For all but one outcome domain, therapists were no better than chance at predicting their measurement-based effectiveness classification. Additionally, controlling for patient baseline impairment, therapists who consistently overestimated their problem-specific effectiveness had patients who reported worse global outcomes than patients whose therapist more accurately estimated their effectiveness. Conversely, therapists who underestimated their problem-specific effectiveness had patients who reported better outcomes than patients whose therapist over- or accurately estimated their effectiveness. CONCLUSIONS Therapist humility may differentiate the most from least globally effective therapists, and this virtue should be cultivated in clinical trainings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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治疗师对自己基于测量的、针对特定问题的有效性的看法。

客观患者报告的结果数据揭示了治疗师对普通患者的整体有效性（治疗师间效应）和治疗案例中不同问题（治疗师内效应）的差异。然而，目前尚不清楚治疗师如何准确地感知他们自己基于测量的、针对具体问题的有效性，以及这种自我感知是否可以预测治疗师之间的整体表现差异。我们在自然主义心理治疗中探讨了这些问题。方法 对于 50 名治疗师，我们借鉴了平均 27 名既往患者（总 N = 1,363）的数据，这些患者在治疗前和治疗后完成了多维结果测量——治疗结果包 (TOP)。对于 12 个结果领域（例如抑郁、焦虑）中的每一个，TOP 数据将治疗师分类为历史上“有效”、“中性”或“无效”。治疗师不知道他们的数据驱动的分类，他们评估了他们对每个领域的感知有效性。我们进行了卡方分析，以确定治疗师对自己基于测量的有效性分类的预测是否高于偶然水平。然后，我们使用多层次模型来测试治疗师对特定问题的看法是否可以预测治疗师之间的整体表现差异。结果 对于除一个结果领域之外的所有结果领域，治疗师在预测其基于测量的有效性分类方面并没有比机会更好。此外，在控制患者基线损伤的情况下，持续高估其针对特定问题的有效性的治疗师所报告的总体结果比治疗师更准确估计其有效性的患者更差。相反，低估治疗师对特定问题的有效性的患者报告的结果比治疗师高估或准确估计其有效性的患者报告的结果更好。结论 治疗师的谦逊可能是与全球效率最低的治疗师最大的区别，这种美德应该在临床培训中培养。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。