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Outcome research in psychotherapy has proceeded remarkably, and that the effects of psychotherapy are statistically and clinically significant is empirically well founded. But “much more research needs to be conducted before the exact relationship between the process of the therapy and its outcome will be known” (Lambert and Ogles 2004, p. 181). For that reason, the focus of psychotherapy research has shifted from investigating outcome to a process-outcome approach. Following Laurenceau, Hayes, and Feldman (2007), process-outcome research addresses three sets of questions: For whom and under what conditions does change occur? (moderators of change); What is the shape of change? (trajectories of change); and Why and how is change occurring? (mediators of change).
The present study focuses on the examination of moderators of change. A moderator is “a characteristic that influences the direction or magnitude of the relationship between an independent and a dependent variable” (Kazdin 2007, p. 3). Moderators precede treatment and are not correlated with it (Kraemer et al. 2002). Identifying them helps in the prognosis of a course of therapy and in matching different patients to treatments. We included as putative moderators (1) treatment parameters (treatment modality, dose [session frequency x duration], therapeutic alliance), (2) sociodemographic variables (age, sex, partnership status), and (3) clinical patients' characteristics (diagnosis of personality disorder, emotional lability, and extraversion).