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Alliance psychotherapy

Elfrida Hartveit Kvarstein, Ola Nordviste, Lone Dragland, Theresa Wilberg
OBJECTIVES: Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. METHODS: A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models...
October 21, 2016: Personality and Mental Health
Sigal Zilcha-Mano
Many therapists regard alliance ruptures as one of the greatest challenges therapists face in the therapy room. Alliance ruptures has been previously defined as breakdowns in the process of negotiation of treatment tasks and goals and a deterioration in the affective bond between patient and therapist. Alliance ruptures have been found to predict premature termination of treatment and poor treatment outcomes. But ruptures can also present important opportunities for gaining insight and awareness and for facilitating therapeutic change...
October 17, 2016: Clinical Child Psychology and Psychiatry
Michael J Constantino, Holly B Laws, Alice E Coyne, Roger P Greenberg, Daniel N Klein, Rachel Manber, Barbara O Rothbaum, Bruce A Arnow
Objective: Theories posit that chronically depressed individuals have hostile and submissive interpersonal styles that undermine their interpersonal effectiveness and contribute to the cause and maintenance of their depression. Recent findings support this theory and demonstrate that chronically depressed patients' interpersonal impacts on their therapist become more adaptive (i.e., less hostile and submissive, and more friendly and assertive) during a targeted chronic depression treatment: cognitive-behavioral analysis system of psychotherapy (CBASP)...
October 17, 2016: Journal of Consulting and Clinical Psychology
Uwe Altmann, Désirée Thielemann, Bernhard Strauß
There is a growing body of literature recognizing the importance of outpatient psychotherapy. Several studies investigated the efficacy of outpatient psychotherapy and aspects of the health care system under natural conditions. This paper gives an overview of studies from German speaking countries (TRANS-OP-, TK-, PAP-S- and QS-PSY-BAY-study).The results of the different studies indicate both, positive outcome of the therapies (e. g., reduction of symptoms with an average ES of 1,03; improvement of symptoms despite premature termination) as well as an economic benefit (end of treatment depending on treatment outcome and not limited by therapy sessions; extensions of psychotherapy only if patient is highly impaired and therapeutic alliance is positive; high reduction of supply costs and sick leave)...
October 2016: Psychiatrische Praxis
Danielle Magaldi, Leora Trub
OBJECTIVE: Spiritual/religious/non-religious (S/R/N) identity development is often neglected in psychotherapy training and represents an area where psychotherapists feel they lack competence. Such feelings can become even more pronounced when it comes to S/R/N self-disclosure. This study explores the decisions therapists make regarding self-disclosure, which impacts the psychotherapy process. METHOD: This grounded theory study explores psychotherapists' S/R/N self-disclosure based on qualitative interviews with 21 psychotherapists representing varied theoretical orientations and spiritual, religious, atheist, and agnostic backgrounds...
October 6, 2016: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Janice L Krupnick, Bonnie L Green, Richard Amdur, Adil Aloui, Anas Beloui, Erika Roberge, David Cueva, Miguel Roberts, Elizabeth Melnikoff, Mary Ann Dutton
Objective: Veterans suffering from posttraumatic stress disorder (PTSD) may avoid or fail to follow through with a full course of face-to-face mental health treatment for a variety of reasons. We conducted a pilot effectiveness trial of an online intervention for veterans with current PTSD to determine the feasibility, safety, and preliminary effectiveness of an online writing intervention (i.e., Warriors Internet Recovery & EDucation [WIRED]) as an adjunct to face-to-face psychotherapy. Method: Veterans (N = 34) who had served in Iraq or Afghanistan with current PTSD subsequent to deployment-related trauma were randomized to Veterans Affairs (VA) mental health treatment as usual (TAU) or to treatment as usual plus the online intervention (TAU + WIRED)...
September 8, 2016: Psychological Trauma: Theory, Research, Practice and Policy
Andreea Vîslă, Michael J Constantino, Katie Newkirk, John S Ogrodniczuk, Ingrid Söchting
OBJECTIVE: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy...
August 5, 2016: Psychotherapy Research: Journal of the Society for Psychotherapy Research
O Giotakos, E Papadomarkaki
Over the last few years, Internet has become an integral part of daily life. An abundant source of information and a principal gateway of communication between individuals, Internet has been continuously gaining considerable ground as a tool of awareness and intervention in the area of public health. With regard to the field of mental health, Internet exhibits a credible potential in facilitating dialogue not only between experts and their beneficiaries but also between stakeholders. Moreover and with regard to various aspects of public concern, it can serve as a circulation portal of educational material between students and teachers...
April 2016: Psychiatrikē, Psychiatriki
John Weisz, Sarah Kate Bearman, Lauren C Santucci, Amanda Jensen-Doss
To address implementation challenges faced by some evidence-based youth psychotherapies, we developed an efficient transdiagnostic approach-a potential "first course" in evidence-based treatment (EBP)-guided by five empirically supported principles of therapeutic change. An open trial of the resulting FIRST protocol was conducted in community clinics. Following a 2-day training, staff practitioners treated 24 clinically referred youths ages 7-15, 50% male, 87% White and 13% Latino, all with the Schedule for Affective Disorders and Schizophrenia for School-Age Children Diagnostic and Statistical Manual of Mental Disorders (4th ed...
July 21, 2016: Journal of Clinical Child and Adolescent Psychology
Yakov Shapiro, Nicholas John, Rowan Scott, Nadia Tomy
In the first article in this 2-part series, we outlined a psychobiological model of psychiatric treatment and reviewed the evidence showing psychotherapy to be a form of biological intervention that induces lasting alterations in brain structure and function. In this second article, we focus on the adaptive model of psychopathology, the effectiveness of psychotherapeutic interventions, the synergistic effects of combined psychotherapy and psychopharmacology treatments, and attention to the patient's subjective experience and the doctor-patient alliance to complement an "objective" case formulation...
July 2016: Journal of Psychiatric Practice
Christian G Widschwendter, Alex Hofer, Susanne Baumgartner, Monika Edlinger, Georg Kemmler, Maria A Rettenbacher
OBJECTIVE: The quality of the patient-psychiatrist relationship can be seen as a cornerstone of adherence to medications in patients with chronic psychiatric disorders. Although therapeutic alliance in psychotherapy has been investigated broadly, it has received little attention in the context of medication adherence. The goal of this study was to develop and validate a user-friendly questionnaire for the assessment of therapeutic alliance in clinically stable outpatients with schizophrenia...
July 2016: Journal of Psychiatric Practice
Jacob B Nienhuis, Jesse Owen, Jeffrey C Valentine, Stephanie Winkeljohn Black, Tyler C Halford, Stephanie E Parazak, Stephanie Budge, Mark Hilsenroth
OBJECTIVE: Alliance, empathy, and genuineness are each integral parts of the therapeutic relationship. No previous meta-analysis has explored the extent to which therapist empathy and genuineness contribute to the therapeutic alliance. METHOD: In this meta-analysis, a multifaceted search strategy yielded 53 studies. Forty studies reported alliance/empathy relationships, eight studies reported alliance/genuineness relationships, and five studies reported both. RESULTS: Random effects meta-analyses revealed that therapeutic alliance was significantly related to perceptions of therapist empathy with a mean r = 0...
July 7, 2016: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Sander L Koole, Wolfgang Tschacher
During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship- or alliance- and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy...
2016: Frontiers in Psychology
Jennifer M Doran, Jeremy D Safran, J Christopher Muran
OBJECTIVE: This study examines the validity of the Alliance Negotiation Scale (ANS) in a psychotherapy research program. Analyses were designed to evaluate the relationship between the ANS and psychotherapy process and outcome variables. METHOD: Data were collected in a metropolitan psychotherapy research program. Participants completed 30 sessions of therapy, postsession assessments, and a battery of measures at intake and termination. RESULTS: Relationships were found between the ANS and session outcome, working alliance, and the presence of ruptures and their resolution...
July 5, 2016: Journal of Clinical Psychology
D Fraguas, C M Díaz-Caneja, M W State, M C O'Donovan, R E Gur, C Arango
Personalized or precision medicine is predicated on the assumption that the average response to treatment is not necessarily representative of the response of each individual. A commitment to personalized medicine demands an effort to bring evidence-based medicine and personalized medicine closer together. The use of relatively homogeneous groups, defined using a priori criteria, may constitute a promising initial step for developing more accurate risk-prediction models with which to advance the development of personalized evidence-based medicine approaches to heterogeneous syndromes such as schizophrenia...
June 23, 2016: Psychological Medicine
Heather Thompson-Brenner
The available forms of psychotherapy for anorexia nervosa (AN) are helpful to many patients; however, a substantial proportion of adults with AN continues to show persistent symptoms and medical risks following treatment. Clinical investigators are therefore developing innovative adjunctive treatments for adults, to augment treatment effects. The 3 cases in this special section each demonstrate a creative, potent adjunctive treatment approach: Exposure and Response Prevention, Cognitive Remediation Therapy, and Unified Couples Therapy...
June 2016: Psychotherapy
Lauren K Richards, Rebecca M Shingleton, Rachel Goldman, Deborah Siegel, Heather Thompson-Brenner
Both cognitive-behavioral therapy (CBT) and psychodynamic psychotherapy are commonly used to treat eating disorders. To further investigate the effectiveness of integrative dynamic therapy (IDT) for bulimia nervosa (BN), our research group undertook a randomized, controlled pilot study comparing IDT with CBT for BN. The case described here was selected from a sample of N = 38 female patients with the symptoms of BN who enrolled in the study. IDT incorporated aspects of the first 4-week stage of CBT, including psychoeducation, self-monitoring, and regular eating...
June 2016: Psychotherapy
Gunter Schiepek, Benjamin Aas, Kathrin Viol
Psychotherapy is a dynamic process produced by a complex system of interacting variables. Even though there are qualitative models of such systems the link between structure and function, between network and network dynamics is still missing. The aim of this study is to realize these links. The proposed model is composed of five state variables (P: problem severity, S: success and therapeutic progress, M: motivation to change, E: emotions, I: insight and new perspectives) interconnected by 16 functions. The shape of each function is modified by four parameters (a: capability to form a trustful working alliance, c: mentalization and emotion regulation, r: behavioral resources and skills, m: self-efficacy and reward expectation)...
July 2016: Nonlinear Dynamics, Psychology, and Life Sciences
Karina L Allen, Caitlin B O'Hara, Savani Bartholdy, Beth Renwick, Alexandra Keyes, Anna Lose, Martha Kenyon, Hannah DeJong, Hannah Broadbent, Rachel Loomes, Jessica McClelland, Lucy Serpell, Lorna Richards, Eric Johnson-Sabine, Nicky Boughton, Linette Whitehead, Janet Treasure, Tracey Wade, Ulrike Schmidt
OBJECTIVE: Case formulation is a core component of many psychotherapies and formulation letters may provide an opportunity to enhance the therapeutic alliance and improve treatment outcomes. This study aimed to determine if formulation letters predict treatment satisfaction, session attendance, and symptom reductions in anorexia nervosa (AN). It was hypothesized that higher quality formulation letters would predict greater treatment satisfaction, a greater number of attended sessions, and greater improvement in eating disorder symptoms...
September 2016: International Journal of Eating Disorders
Elon Gersh, Carol A Hulbert, Ben McKechnie, Reem Ramadan, Tamara Worotniuk, Andrew M Chanen
OBJECTIVES: This study aimed to investigate alliance rupture and repair processes in psychotherapy for youth with borderline personality disorder. It sought to examine whether alliance processes differ between treatments, across the phases of therapy, and what associations these processes might have with therapeutic outcomes. DESIGN: The study involves repeated measurement of both process and outcome measures. Hypotheses were addressed using within- and between-subjects analyses...
May 30, 2016: Psychology and Psychotherapy
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