Therapists and their patients: Similarities and differences in attitudes between four psychotherapy orientations in Sweden

Abstract: The aim of this thesis was to illuminate the possibilities and obstacles for therapists of different orientations to communicate and cooperate better with each other. Data was collected by a questionnaire named VEP-Q. Similarities and differences in attitudes between psychotherapists of four different orientations - working with adults in individual therapy - were surveyed. 416 therapists with an identity as either a psychodynamic (PDT), a cognitive (CT), a cognitive behavioral (CBT), or a integrative eclectic (IE) therapists, were compared. A client version of VEP-Q was distributed to patients. In Study I similarities and differences between the therapists of the four orientations were described regarding (1) background factors, (2) focus in psychotherapy, (3) attitudes towards psychotherapy as art/craftsmanship, (4) scientific outlook, (5) what characterizes a good psychotherapist, and (6) how psychotherapy ought to be pursued. The therapists had very similar attitudes about the therapeutic relationship and rather similar attitudes about which effects psychotherapy ought to obtain. The greatest differences were related to psychotherapeutic techniques and science. In Study II, a factor analysis regarding 17 items about to how psychotherapy ought to be pursued was conducted. The factor analysis resulted in three scales, a PDT, a CBT and a common factor (CF) scale. In addition to theoretical orientation, variables such as gender and basic professional training influenced how respondents answered the VEP-Q. In Study III, the aim was to investigate if psychotherapists misjudge other orientations following a pattern from group psychology; overrating positive aspects in their own group and having prejudiced attitudes towards other groups. The study showed that psychotherapists can evaluate correctly therapists of their own orientation. However, psychotherapists exaggerate the differences between their own and other orientations in a prejudiced way. In Study IV, patients’ preferences about how psychotherapy ought to be pursued were compared on a PDT, a CBT and a CF scale. The patients had rather similar preferences irrespective of which theoretical orientation they preferred. These similarities were also stable after being in psychotherapy. However, clients with a PDT therapist considered the PDT scale as more important than clients in other orientations did, and women rated the CF scale as more important than men did. The clients preferences were also compared with the therapists preferences. While the clients’ ratings centered around the scales midpoint, the therapists’ ratings differed more, and they often rated the scales higher than the clients did. The general conclusion in the thesis is that there still are important differences between theoretical orientations in psychotherapy, but the extent of these differences often are exaggerated, and the phenomena of ingroup/outgroup thinking among psychotherapists is an explanation to why the differences are exaggerated.