دورية أكاديمية
Working alliance in exposure-based treatments of posttraumatic stress disorder related to childhood abuse.
| العنوان: | Working alliance in exposure-based treatments of posttraumatic stress disorder related to childhood abuse. |
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| المؤلفون: | Oprel DAC; Leiden University, Department of Clinical Psychology., Hoeboer CM; Leiden University, Department of Clinical Psychology., Schoorl M; Leiden University, Department of Clinical Psychology., de Kleine RA; Leiden University, Department of Clinical Psychology., van der Does W; Leiden University, Department of Clinical Psychology., van Minnen A; PSYTREC. |
| المصدر: | Journal of consulting and clinical psychology [J Consult Clin Psychol] 2024 Jul; Vol. 92 (7), pp. 399-409. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Psychological Assn Country of Publication: United States NLM ID: 0136553 Publication Model: Print Cited Medium: Internet ISSN: 1939-2117 (Electronic) Linking ISSN: 0022006X NLM ISO Abbreviation: J Consult Clin Psychol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Washington, American Psychological Assn. |
| مواضيع طبية MeSH: | Stress Disorders, Post-Traumatic*/therapy , Stress Disorders, Post-Traumatic*/psychology , Implosive Therapy*/methods , Therapeutic Alliance*, Humans ; Female ; Male ; Adult ; Middle Aged ; Adult Survivors of Child Abuse/psychology ; Treatment Outcome ; Child |
| مستخلص: | Objectives: Working alliance is considered an important determinant of outcome of psychotherapy. Patients with posttraumatic stress disorder (PTSD) following childhood abuse (CA-PTSD) may have challenges in building interpersonal relationships, including working alliance. Phase-based treatment provides an opportunity to strengthen alliance prior to trauma-focused treatment. This study aimed to compare the development of working alliance among patients with CA-PTSD in three variants of prolonged exposure (PE) therapy: standard PE, intensive PE (iPE), and skill training in affective and interpersonal regulation + prolonged exposure (STAIR + PE). We also examined the effect of alliance on treatment outcome and dropout. Method: Self-reported PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (Blevins et al., 2015) and patient-rated Working Alliance Inventory (Tracey & Kokotovic, 1989) were assessed in a clinical trial. We analyzed data from 138 adult patients (76.1% female; 42% non-Western). Analyses were performed using mixed-effects models. Results: Patients established a satisfactory alliance early in treatment, which increased over time. For PE and STAIR + PE, a larger decrease in PTSD symptom severity was related to a higher alliance in the subsequent session, but not the other way around. In STAIR + PE, a higher alliance in Phase 1 was related to lower PTSD symptoms in Phase 2. In all conditions, a higher initial working alliance was related to a lower chance of treatment dropout. Conclusion: In the treatment of CA-PTSD, all three variants of prolonged exposure foster positive development of the working alliance. Across conditions, working alliance did not precede symptom decline. Therapists should strive for a strong alliance at the beginning of treatment as this reduces the likelihood of dropout. (PsycInfo Database Record (c) 2024 APA, all rights reserved). |
| معلومات مُعتمدة: | Netherlands Organisation for Health Research and Development; Innovatiefonds Zorgverzekeraars |
| تواريخ الأحداث: | Date Created: 20240827 Date Completed: 20240827 Latest Revision: 20240909 |
| رمز التحديث: | 20240909 |
| DOI: | 10.1037/ccp0000899 |
| PMID: | 39190444 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1939-2117 |
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| DOI: | 10.1037/ccp0000899 |