Alliance negotiation as a predictor of early treatment outcome.
alliance negotiation
between-patient effects
symptom severity
within-patient effects
Journal
Journal of clinical psychology
ISSN: 1097-4679
Titre abrégé: J Clin Psychol
Pays: United States
ID NLM: 0217132
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
revised:
07
10
2022
received:
14
03
2022
accepted:
08
02
2023
medline:
13
7
2023
pubmed:
23
2
2023
entrez:
22
2
2023
Statut:
ppublish
Résumé
The therapeutic alliance is a robust predictor of treatment outcome. However, little is known about the way alliance negotiation contributes to psychotherapy outcome. The aim of the present study was to analyze the effects of alliance negotiation on treatment outcome in the first four sessions of psychotherapy. Ninety-six patients diagnosed with emotional disorders received weekly Solution-Focused Brief Therapy. Each patient completed both the Alliance Negotiation Scale (ANS) and the Outcome Questionnaire 45 (OQ.45) after each of the first four sessions. Both between- and within-patients effects of alliance negotiation on symptom severity were analyzed using Hierarchical Linear Models. Results showed significant between and within patient effects of alliance negotiation on symptom severity. Patients with higher levels of alliance negotiation across treatment showed lower levels of symptom severity (between-patient effect). Also, in a session with higher alliance negotiation compared to the average session of this patient, symptom severity was lower than in the average session (within-patient effect). The results indicate that therapies characterized by higher alliance negotiation and sessions with higher alliance negotiation are beneficial for early outcome. From a clinical point of view, the results suggest that alliance negotiation is a meaningful factor for therapy outcome and that therapists may benefit from training and monitoring alliance negotiation during the early stages of treatment.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1740-1751Informations de copyright
© 2023 The Authors. Journal of Clinical Psychology published by Wiley Periodicals Inc.
Références
Allen, L., McHugh, R. y, & Barlow, D. (2007). Emotional Disorders a Unified Protocol En. In D. Barlow (Ed.), Clinical Handbook of Psychological Disorders (4ta ed., pp. 578-614). Guilford Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Press.
Ardito, R. B. & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2(270), 270. https://doi.org/10.3389/fpsyg.2011.00270
Baier, A. L., Kline, A. C., & Feeny, N. C. (2020). Therapeutic alliance as a mediator of change: A systematic review and evaluation of research. Clinical Psychology Review, 82, 101921. https://doi.org/10.1016/J.CPR.2020.101921
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16, 252-260.
Castonguay, L. G., Constantino, M. J., & Holtforth, M. G. (2006). The working alliance: Where are we and where should we go? Psychotherapy: Theory, Research, Practice, Training, 43, 271-279.
Casullo, M., & Perez, A. (1999/2008). El inventario de síntomas SCL-90-R de L. Derogatis. Facultad de Psicología, Universidad de Buenos Aires. http://www.fundacionforo.com/pdfs/inventariodesintomas.pdf
Chen, R., Atzil-Slonim, D., Bar-Kalifa, E., Hasson-Ohayon, I., & Refaeli, E. (2016). Therapists' recognition of alliance ruptures as a moderator of change in alliance and symptoms. Psychotherapy Research, 28(4), 560-570. https://doi.org/10.1080/10503307.2016.1227104
Constantino, M. J., Boswell, J. F., Coyne, A. E., Kraus, D. R., & Castonguay, L. G. (2017). Who works for whom and why? Integrating therapist effects analysis into psychotherapy outcome and process research. In L. G. Castonguay, & C. E. Hill (Eds.), How and why are some therapists better than others? Understanding therapist effects (pp. 55-68). American Psychological Association. https://doi.org/10.1037/0000034-004
Coutinho, J., Ribeiro, E., Hill, C., & Safran, J. (2011). Therapists' and clients' experiences of alliance ruptures: A qualitative study. Psychotherapy Research, 21(5), 525-540. https://doi.org/10.1080/10503307.2011.587469
Curran, P. J. & Bauer, D. J. (2011). The disaggregation of within-person and between-person effects in longitudinal models of change. Annual Review of Psychology, 62, 583-619. https://doi.org/10.1146/annurev.psych.093008.100356
Derogatis, L. R. (1994). Symptom checklist-90-R: Administration, scoring and procedures manual (3rd ed.). National Computer Systems.
Dinger, U., Zilcha-Mano, S., Mccarthy, K. S., Barrett, M. S., & Barber, J. P. (2013). Interpersonal problems as predictors of alliance, symptomatic improvement and premature termination in treatment of depression. Journal of Affective Disorders, 151, 800-803. https://doi.org/10.1016/j.jad.2013.07.003
Doran, J. M., Safran, J. D., & Muran, J. C. (2016). The alliance negotiation scale: A psychometric investigation. Psychological Assessment, 28(8), 885-897.
Doran, J. M., Safran, J. D., Waizmann, V., Bolger, K., & Muran, J. C. (2012). The alliance negotiation scale: Psychometric construction and preliminary reliability and validity analysis. Psychotherapy Research, 22(6), 710-719. https://doi.org/10.1080/10503307.2012.709326
Eubanks, C. F., Muran, J. C., & Safran, J. D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55(4), 508-519. https://doi.org/10.1037/pst0000185
Eubanks-Carter, C., Muran, J. C., & Safran, J. D. (2015). Alliance-focused training. Psychotherapy, 52(2), 169-173. https://doi.org/10.1037/a0037596
Falkenström, F., Finkel, S., Sandell, R., Rubel, J. A., & Holmqvist, R. (2017). Dynamic models of individual change in psychotherapy process research. Journal of Consulting and Clinical Psychology, 85(6), 537-549. https://doi.org/10.1037/ccp0000203
Falkenström, F., Granström, F., & Holmqvist, R. (2014). Working alliance predicts psychotherapy outcome even while controlling for prior symptom improvement. Psychotherapy Research, 24(2), 146-159. https://doi.org/10.1080/10503307.2013.847985
Fernández Álvarez, H., Hirsch, H., Maristany, M., & Torrente, F. (2005). Propiedades psicométricas del OQ-45.2 en la Argentina: Un estudio piloto [OQ-45.2 psychometric properties in Argentina: A pilot study], In Trabajo presentado en el Congreso Mundial de Psicoterapias. Buenos Aires.
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. https://doi.org/10.1037/pst0000172
Gómez Penedo, J. M., Zilcha-Mano, S., & Roussos, A. (2019). Interpersonal profiles in emotional disorders predict the importance of alliance negotiation for early treatment outcome. Journal of Consulting and Clinical Psychology, 87(7), 617-628. https://doi.org/10.1037/ccp0000417
Kivlighan, D. M., Jr. & Shaughnessy, P. (2000). Patterns of working alliance development: A typology of client's working alliance ratings. Journal of Counseling Psychology, 47(3), 362-371. https://doi.org/10.1037/0022-0167.47.3.362
Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., & Yanchar, S. C. (1996). The reliability and validity of the outcome questionnaire. Clinical Psychology & Psychotherapy: An International Journal of Theory and Practice, 3(4), 249-258.
Larsson, M., Falkenström, F., Andersson, G., & Holmqvist, R. (2016). Alliance ruptures and repairs in psychotherapy in primary care. Psychotherapy Research, 28, 1-14. https://doi.org/10.1080/10503307.2016.1174345
Leibovich, L., Front, O., McCarthy, K. S., & Zilcha-Mano, S. (2020). How do supportive techniques bring about therapeutic change: The role of therapeutic alliance as a potential mediator. Psychotherapy, 57(2), 151-159. https://doi.org/10.1037/pst0000253
Muran, J. C. & Safran, J. D. (2017). Therapeutic alliance ruptures. Sage Encyclopedia of Abnormal & Clinical Psychology. Sage Publications.
Nisbett, R. E. & Wilson, T. D. (1977). The halo effect: Evidence for unconscious alteration of judgments. Journal of Personality and Social Psychology, 35(4), 250-256.
Raudenbush, S. W. & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (Vol. 1). sage.
Del Re, A. C., Flückiger, C., Horvath, A. O., & Wampold, B. E. (2021). Examining therapist effects in the alliance-outcome relationship: A multilevel meta-analysis. Journal of Consulting and Clinical Psychology, 89(5), 371-378. https://doi.org/10.1037/ccp0000637
de Roten, Y., Fischer, M., Drapeau, M., Beretta, V., Kramer, U., Favre, N., & Despland, J.-N. (2004). Is one assessment enough? Patterns of helping alliance development and outcome. Clinical psychology & psychotherapy, 11(5), 324-331. https://doi.org/10.1002/cpp.420
RStudio Team (2020). RStudio: Integrated Development for R. RStudio, PBC, Boston, MA. http://www.rstudio.com/.
Rubel, J. A., Zilcha-Mano, S., Feils-Klaus, V., & Lutz, W. (2018). Session-to-session effects of alliance ruptures in outpatient CBT: Within- and between-patient associations. Journal of Consulting and Clinical Psychology, 86(4), 354-366. https://doi.org/10.1037/ccp0000286
Safran, J. D. & Kraus, J. (2014). Alliance ruptures, impasses, and enactments: A relational perspective. Psychotherapy, 51(3), 381-387. https://doi.org/10.1037/a0036815
Safran, J. D. & Muran, J. C. (2006). Has the concept of the therapeutic alliance outlived its usefulness. Psychotherapy: Theory, research, practice, training, 43(3), 286-291. https://doi.org/10.1037/0033-3204.43.3.286
Safran, J. D., Muran, J. C., & Proskurov, B. (2009). Alliance, negotiation, and rupture resolution. In R. Levy, & J. S. Ablon (Eds.), Handbook of evidence-based psychodynamic psychotherapy: Bridging the gap between science and practice (pp. 221-226). Springer.
Safran, J., Muran, J. C., Samstag, L., & Stevens, C. (2002). Repairing alliance ruptures. In J. C. Norcross (Ed.), Psychotherapy Relations that Work: Therapist contributions and responsiveness to patients (pp. 235-254). Oxford University Press.
De Shazer, S. & Berg, I. K. (1997). ‘What works?' Remarks on research aspects of solution-focused brief therapy. Journal of Family therapy, 19(2), 121-124. https://doi.org/10.1111/1467-6427.00043
De Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar, A., Gingerich, W., & Weiner-Davis, M. (1986). Brief therapy: Focused solution development. Family Process, 25(2), 207-221.
Solution-Focused Brief Therapy Research Committee (2007). Solution focused therapy treatment manual for working with individuals research committee of the solution focused brief therapy association. Obtenido el 25 de Mayo de 2015, de la página de la Solution-Focused Brief Therapy Association: http://www.sfbta.org/Research.pdf.
Stiles, W. B., Glick, M. J., Osatuke, K., Hardy, G. E., Shapiro, D. A., Agnew-Davies, R., Rees, A., & Barkham, M. (2004). Patterns of alliance development and the Rupture-Repair hypothesis: Are productive relationships U-Shaped or V-Shaped? Journal of Counseling Psychology, 51(1), 81-92. https://doi.org/10.1037/0022-0167.51.1.81
Stiles, W. B., Honos-Webb, L., & Surko, M. (1998). Responsiveness in psychotherapy. Clinical Psychology: Science and Practice, 5(4), 439-458. https://doi.org/10.1111/J.1468-2850.1998.TB00166.X
Talbot, C., Ostiguy-Pion, R., Painchaud, E., Lafrance, C., & Descôteaux, J. (2019). Detecting alliance ruptures: The effects of the therapist's experience, attachment, empathy and countertransference management skills. Research in psychotherapy (Milano), 22(1), 325. https://doi.org/10.4081/ripppo.2019.325
Wachtel, P. L. (2008). Relational theory and the practice of psychotherapy. Guilford Press.
Waizmann, V., Doran, J., Bolger, K., Penedo, J. M. G., Safran, J., & Roussos, A. (2015). Escala de negociación de alianza terapéutica (ANS-A): Evidencias de su validez y confiabilidad. Revista Argentina de Clínica Psicológica, 24(3), 243-254.
Wang, L. & Maxwell, S. E. (2015). On disaggregating between-person and within-person effects with longitudinal data using multilevel models. Psychological Methods, 20(1), 63-83. https://doi.org/10.1037/met0000030
Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating motivational interviewing with cognitive-behavioral therapy for severe generalized anxiety disorder: An allegiance-controlled randomized clinical trial. Journal of Consulting and Clinical Psychology, 84(9), 768-782. https://doi.org/10.1037/ccp0000098
Zilcha-Mano, S. & Errázuriz, P. (2017). Early development of mechanisms of change as a predictor of subsequent change and treatment outcome: The case of working alliance. Journal of Consulting and Clinical Psychology, 85(5), 508-520. https://doi.org/10.1037/ccp0000192