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therapeutic alliance, therapeutic collaboration, process therapeutic, outcome

Ilanit Hasson-Ohayon, Shlomo Kravetz, Paul H Lysaker
: Agreement between client and therapist is an essential part of the therapeutic alliance. While there are general challenges to the creation of agreement and shared meaning in all psychotherapies, there are specific challenges while working with persons with psychosis. These challenges include the different narratives of the client and the therapist with regard to their roles and the description of the condition or problem, as well as possible stigmatic views and theoretical bias. Here we present a metacognitive intersubjective model as a framework for the understanding and resolutions of these challenges...
March 14, 2016: Clinical Psychology & Psychotherapy
Sima Sandhu, Eleonora Arcidiacono, Eugenio Aguglia, Stefan Priebe
Reciprocity has generally been understood as a process of giving and taking, within an exchange of emotions or services, and has long been recognized as a central part of human life. However, an understanding of reciprocity in professional helping relationships has seldom received attention, despite movements in mental health care towards more collaborative approaches between service users and professionals. In this review, a systematic search of the published papers was conducted in order to explore how reciprocity is conceptualized and understood as part of the dyadic therapeutic relationship between professionals and service users...
December 2015: International Journal of Mental Health Nursing
Deborah F Siegel, Mark J Hilsenroth
This study investigates the relationships between patient ratings of in-session safety with psychotherapeutic techniques and process. Ninety-four participants received Short-Term Dynamic Psychotherapy (STDP) at a university-based clinic. Patient experiences of therapeutic process were self-assessed early in treatment using the Session Evaluation Questionnaire (SEQ Stiles, 1980). Techniques implemented in session were identified using the Comparative Psychotherapy Process Scale (CPPS: Hilsenroth et al., 2005)...
2013: American Journal of Psychotherapy
Dennis M Kivlighan, Cheri L Marmarosh, Mark J Hilsenroth
Actor-partner interdependence modeling (APIM; Kashy & Kenny, 2000) was used to study the early therapeutic alliance in 74 clients being treated by 29 therapists to explore the relationship between the alliance and treatment progress, while prioritizing the dyadic nature of the alliance. The APIM examines collaboration/influence by modeling the impact of one dyad member's alliance ratings on the other member's session impact rating (partner effects). In terms of the alliance, the results revealed significant client-actor effects for client ratings of session depth and positivity as well as significant therapist-actor effects for therapist ratings of session smoothness and positivity...
January 2014: Journal of Counseling Psychology
Eugénia Ribeiro, António P Ribeiro, Miguel M Gonçalves, Adam O Horvath, William B Stiles
BACKGROUND: The quality and strength of the therapeutic collaboration, the core of the alliance, is reliably associated with positive therapy outcomes. The urgent challenge for clinicians and researchers is constructing a conceptual framework to integrate the dialectical work that fosters collaboration, with a model of how clients make progress in therapy. AIM: We propose a conceptual account of how collaboration in therapy becomes therapeutic. In addition, we report on the construction of a coding system - the therapeutic collaboration coding system (TCCS) - designed to analyse and track on a moment-by-moment basis the interaction between therapist and client...
September 2013: Psychology and Psychotherapy
David A Jobes
The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based clinical intervention that has significantly evolved over 25 years of clinical research. CAMS is best understood as a therapeutic framework that emphasizes a unique collaborative assessment and treatment planning process between the suicidal patient and clinician. This process is designed to enhance the therapeutic alliance and increase treatment motivation in the suicidal patient. Central to the CAMS approach is the use of the Suicide Status Form (SSF), which is a multipurpose clinical assessment, treatment planning, tracking, and outcome tool...
December 2012: Suicide & Life-threatening Behavior
Christian A Webb, Robert J Derubeis, Sona Dimidjian, Steven D Hollon, Jay D Amsterdam, Richard C Shelton
OBJECTIVE: Previous research has found that therapist adherence to concrete, problem-focused cognitive therapy (CT) techniques predicts depressive symptom change (e.g., Feeley, DeRubeis, & Gelfand, 1999). More recently, Strunk, DeRubeis, Chui, and Alvarez (2007) demonstrated that in-session evidence of patients' use of CT skills was related to a lower rate of relapse in the year following CT for depression. The current investigation attempts to integrate and extend these findings within 2 separate samples of patients and therapists...
June 2012: Journal of Consulting and Clinical Psychology
Lotte Smith-Hansen, Michael J Constantino, Alessandro Piselli, Anna L Remen
This study examined the preliminary results of an integrative, video-assisted training workshop aimed at helping psychotherapists build strong therapeutic relationships with their clients. Participants were 57 clinicians across five community mental health clinics, who were randomly assigned to the brief alliance-training workshop (in which they participated prior to starting treatment with a new client) or to a delayed-training control condition. Outcomes assessed included therapist-reported use of alliance strategies during Session 1, therapist-rated alliance quality after Session 1, and client engagement across the first 4 weeks...
June 2011: Psychotherapy
Jeremy D Safran, J Christopher Muran, Catherine Eubanks-Carter
In this article, we review the existing empirical research on the topic of therapeutic alliance ruptures in psychotherapy. Ruptures in the therapeutic alliance are defined as episodes of tension or breakdown in the collaborative relationship between patient and therapist. Two meta-analyses were conducted. The first reviewed studies examining the relation between rupture-repair episodes and treatment outcome (r = .24, z = 3.06, 95% CI [.09, .39], p = .002, k = 3, N = 148). The second meta-analysis reviewed the research examining the impact on treatment outcome of training therapists in the use of alliance rupture intervention principles (prepost r = ...
March 2011: Psychotherapy
Michela Gatta, Elisabetta Ramaglioni, Jessica Lai, Lorenza Svanellini, Irene Toldo, Lara Del Col, Cinzia Salviato, Andrea Spoto, Battistella Pier Antonio
The aim of the study is to analyze the clinician's alliance with parents during the diagnostic process in relation to therapeutic compliance and clinical evolution of individuals aged 0-11 years. The sample was formed by 84 individuals aged 0 to 11 years (18 < 6 years, 66 aged 6 to 11 years; 62 males and 22 females) who came to the Neuropsychiatric Unit for Children and Adolescents for a consultation regarding psychorelational and behavioral problems. Neuropsychiatric consultation took place in five diagnostic interviews with child and parents, separately...
2009: Neuropsychiatric Disease and Treatment
Michael Schönberger, Frank Humle, Thomas W Teasdale
OBJECTIVE: To investigate the relationship between working alliance, compliance, awareness and subjective outcome of brain injury rehabilitation. Subjects were 86 patients who were clients in an holistic neuropsychological outpatient rehabilitation programme. They had suffered a traumatic brain injury (n = 27), a cerebrovascular accident (n = 49) or some other neurological insult (n = 10). MEASURES: The therapeutic alliance, clients' awareness and their compliance were rated four times during the 14-week rehabilitation programme...
November 2006: Brain Injury: [BI]
Casey T Taft, Christopher M Murphy, Daniel W King, Peter H Musser, Judith M DeDeyn
This study used multilevel modeling to examine process and treatment adherence factors as predictors of collateral partner reports of abuse following participation in a cognitive-behavioral grouptreatment program for partner violent men (N = 107). Therapist working alliance ratings predicted lower levels of physical and psychological abuse at the 6-month follow-up and were the strongest predictors of outcome. Homework compliance partially mediated associations between early alliance ratings and psychological abuse at follow-up...
August 2003: Journal of Consulting and Clinical Psychology
J P Barber, L Luborsky, R Gallop, P Crits-Christoph, A Frank, R D Weiss, M E Thase, M B Connolly, M Gladis, C Foltz, L Siqueland
The authors examined the relation between therapeutic alliance, retention, and outcome for 308 cocaine-dependent outpatients participating in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. High levels of alliance were observed in supportive-expressive therapy (SE), cognitive therapy (CT), and individual drug counseling (IDC), and alliance levels increased slightly but significantly from Session 2 to Session 5 in all groups. In contrast to other studies, alliance was not a significant predictor of drug outcome...
February 2001: Journal of Consulting and Clinical Psychology
S J Ackerman, M J Hilsenroth, M R Baity, M D Blagys
Utilizing a collaborative therapeutic assessment (TA) model proposed by Finn and Tonsager (1997), we examined the interaction between therapeutic alliance and in-session process during the assessment phase of treatment. This study compares the utility of the TA model (n = 38) versus a traditional information gathering model (n = 90) of assessment. The results of this study indicate that the use of a TA model may decrease the number of patients who terminate treatment against medical advice. The Session Evaluation Questionnaire (Stiles & Snow, 1984), Combined Alliance Short Form (Hatcher & Barends, 1996), and Penn Helping Alliance Questionnaire-Revised (Barber & Crits-Christoph, 1996) can reliably measure the patient's experience of the assessment...
August 2000: Journal of Personality Assessment
D C Zuroff, S J Blatt, S M Sotsky, J L Krupnick, D J Martin, C A Sanislow, S Simmens
Prior analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program demonstrated that perfectionism was negatively related to outcome, whereas both the patient's perception of the quality of the therapeutic relationship and the patient contribution to the therapeutic alliance were positively related to outcome across treatment conditions (S. J. Blatt, D. C. Zuroff, D. M. Quinlan, & P. A. Pilkonis, 1996; J. L. Krupnick et al., 1996). New analyses examining the relations among perfectionism, perceived relationship quality, and the therapeutic alliance demonstrated that (a) the patient contribution to the alliance and the perceived quality of the therapeutic relationship were independent predictors of outcome, (b) perfectionistic patients showed smaller increases in the Patient Alliance factor over the course of treatment, and (c) the negative relation between perfectionism and outcome was explained (mediated) by perfectionistic patients' failure to develop stronger therapeutic alliances...
February 2000: Journal of Consulting and Clinical Psychology
K M Carroll, G J Connors, N L Cooney, C C DiClemente, D M Donovan, R R Kadden, R L Longabaugh, B J Rounsaville, P W Wirtz, A Zweben
Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) is a multisite collaborative project designed to evaluate patient-treatment interactions in alcoholism treatment. To evaluate whether major threats to the internal validity of the independent (treatment) variable in Project MATCH could be ruled out, we investigated several aspects of treatment integrity and discriminability. In this study, 1,726 alcohol-dependent participants at 10 sites were randomized to 3 treatments: cognitive-behavioral treatment (CBT), motivational enhancement therapy (MET), and 12-step facilitation (TSF)...
April 1998: Journal of Consulting and Clinical Psychology
E Hougaard
The role and function of the therapeutic alliance in psychotherapy has increasingly been the focus of clinicians' and researchers' interests over the last decade. Alliance concepts have, however, been criticized for lack of conceptual clarity. The paper presents a generic model as a heuristic means for clarifying the conceptual meaning of the therapeutic alliance. The model distinguishes between the personal relationship aspect, and the collaborative, task-related aspect of the alliance, with therapist, patient, and common contributions to each of these aspects...
March 1994: Scandinavian Journal of Psychology
K Moras, H H Strupp
This study examined the relationship between pretherapy clinical assessments of interpersonal relations and (1) patients' therapeutic alliance and (2) outcome in time-limited psychotherapy (up to 25 sessions). For 33 college men with symptoms of depression, anxiety, and social introversion, clinical judgments of interpersonal relations predicted patients' level of collaborative, positively toned participation in a therapeutic relationship, accounting for up to a quarter of the variance in observers' ratings of audiotaped segments from therapy sessions...
April 1982: Archives of General Psychiatry
E R Ryan, D V Cicchetti
A constellation of theoretically relevant pretherapy patient variables--object relations, psychological mindedness, hope for success, psychic pain, and intrapsychic flexibility--were used to predict patient therapeutic alliance readiness during the initial psychoanalytic psychotherapy interview. Therapeutic alliance readiness was viewed as a dual concept, assessed by psychological freedom, a variable measuring patient expressiveness, and quality of alliance, a variable measuring patient collaborativeness. A significant amount of the variance (approximately 40%) in the combined dependent alliance readiness variables was predicted from the pretherapy constellation of variables...
December 1985: Journal of Nervous and Mental Disease
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