The impact of client-perceived therapist variables on exposure therapy for agoraphobia

This study examined the relationship between therapist characteristics and treatment outcome in in vivo exposure treatment for agoraphobia. The Therapist Rating Scale was developed as a measure of client perception of 17 dimensions of therapist characteristics. Each of its 66 items demonstrated significant test-retest reliability. Twelve of the 17 dimensions demonstrated satisfactory internal consistency. The scale was administered to 27 agoraphobics participating in a 10-session in vivo exposure treatment program. Client improvement was assessed via residual gain on the Behavioral Test Hierarchy performance score. When the total sample was considered, there were significant correlations between improvement and the following therapist characteristics: modeling self-confidence, respectfulness, congruence, and challenging behaviors. Results were similar for nonmedicated clients considered alone. However, there were no significant correlations when female subjects were considered separately. It is possible that client gender and/or crossed-sex therapy pairing may influence the relationship between client-perceived therapist characteristics and treatment outcome.