Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders / Krister W. FJERMESTAD in Journal of Child Psychology and Psychiatry, 57-5 (May 2016)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.625-632 Titre : Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders Type de document : Texte imprimé et/ou numérique Auteurs : Krister W. FJERMESTAD, Auteur ; Matthew D. LERNER, Auteur ; Bryce D. MCLEOD, Auteur ; Gro Janne WERGELAND, Auteur ; Einar R. HEIERVANG, Auteur ; Wendy K. SILVERMAN, Auteur ; Lars-Göran ÖST, Auteur ; Andres DE LOS REYES, Auteur ; Odd E. HAVIK, Auteur ; Bente S. M. HAUGLAND, Auteur Article en page(s) : p.625-632 Langues : Anglais (eng) Mots-clés : Alliance  alliance agreement  CBT  anxiety  youth Index. décimale : PER Périodiques Résumé : Background In individual cognitive behavioral therapy (ICBT) for youth anxiety disorders, it is unclear whether, and from whose perspective, the alliance predicts outcome. We examined whether youth- and therapist-rated alliance, including level of youth-therapist alliance agreement, predicted outcome in a randomized controlled trial. Methods Youth (N = 91, M age = 11.4 years (SD = 2.1), 49.5% boys, 86.8% Caucasian) diagnosed with separation anxiety disorder, social phobia, or generalized anxiety disorder drawn from the ICBT condition of an effectiveness trial were treated with an ICBT program. Youth- and therapist-rated alliance ratings, assessed with the Therapeutic Alliance Scale for Children (TASC-C/T), were collected following session 3 (early) and 7 (late). Early alliance, change in alliance from early to late, and level of youth-therapist agreement on early alliance and alliance change were examined, in relation to outcomes collected at posttreatment and 1-year follow-up. Outcome was defined as primary diagnosis loss and reduction in clinicians' severity ratings (CSR; Anxiety Disorders Interview Schedule; ADIS-C/P) based on youth- and parent-report at posttreatment and follow-up, and youth treatment satisfaction collected at posttreatment (Client Satisfaction Scale; CSS). Results Early TASC-C scores positively predicted treatment satisfaction at posttreatment. Higher levels of agreement on change in TASC-C and TASC-T scores early to late in treatment predicted diagnosis loss and CSR reduction at follow-up. Conclusions Only the level of agreement in alliance change predicted follow-up outcomes in ICBT for youth anxiety disorders. The findings support further examination of the role that youth-therapist alliance discrepancies may play in promoting positive outcomes in ICBT for youth anxiety disorders. Clinical trial number NCT00586586, clinicaltrials.gov. En ligne : http://dx.doi.org/10.1111/jcpp.12485 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=288 [article] Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders [Texte imprimé et/ou numérique] / Krister W. FJERMESTAD, Auteur ; Matthew D. LERNER, Auteur ; Bryce D. MCLEOD, Auteur ; Gro Janne WERGELAND, Auteur ; Einar R. HEIERVANG, Auteur ; Wendy K. SILVERMAN, Auteur ; Lars-Göran ÖST, Auteur ; Andres DE LOS REYES, Auteur ; Odd E. HAVIK, Auteur ; Bente S. M. HAUGLAND, Auteur . - p.625-632. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.625-632 Mots-clés : Alliance  alliance agreement  CBT  anxiety  youth Index. décimale : PER Périodiques Résumé : Background In individual cognitive behavioral therapy (ICBT) for youth anxiety disorders, it is unclear whether, and from whose perspective, the alliance predicts outcome. We examined whether youth- and therapist-rated alliance, including level of youth-therapist alliance agreement, predicted outcome in a randomized controlled trial. Methods Youth (N = 91, M age = 11.4 years (SD = 2.1), 49.5% boys, 86.8% Caucasian) diagnosed with separation anxiety disorder, social phobia, or generalized anxiety disorder drawn from the ICBT condition of an effectiveness trial were treated with an ICBT program. Youth- and therapist-rated alliance ratings, assessed with the Therapeutic Alliance Scale for Children (TASC-C/T), were collected following session 3 (early) and 7 (late). Early alliance, change in alliance from early to late, and level of youth-therapist agreement on early alliance and alliance change were examined, in relation to outcomes collected at posttreatment and 1-year follow-up. Outcome was defined as primary diagnosis loss and reduction in clinicians' severity ratings (CSR; Anxiety Disorders Interview Schedule; ADIS-C/P) based on youth- and parent-report at posttreatment and follow-up, and youth treatment satisfaction collected at posttreatment (Client Satisfaction Scale; CSS). Results Early TASC-C scores positively predicted treatment satisfaction at posttreatment. Higher levels of agreement on change in TASC-C and TASC-T scores early to late in treatment predicted diagnosis loss and CSR reduction at follow-up. Conclusions Only the level of agreement in alliance change predicted follow-up outcomes in ICBT for youth anxiety disorders. The findings support further examination of the role that youth-therapist alliance discrepancies may play in promoting positive outcomes in ICBT for youth anxiety disorders. Clinical trial number NCT00586586, clinicaltrials.gov. En ligne : http://dx.doi.org/10.1111/jcpp.12485 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=288

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