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Practitioner Review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta-analysis / Regina MURPHY in Journal of Child Psychology and Psychiatry, 59-1 (January 2018)
[article]
Titre : Practitioner Review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta-analysis Type de document : Texte imprimé et/ou numérique Auteurs : Regina MURPHY, Auteur ; Paul HUTTON, Auteur Article en page(s) : p.5-19 Langues : Anglais (eng) Mots-clés : Alliance alliance-outcome relationship adolescent therapy therapist variability meta-analysis Index. décimale : PER Périodiques Résumé : Background Previous meta-analyses have only found small correlations (r = .10 to r = .19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study-level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta-analysis aimed to address this gap by using patient-therapist ratio as a moderator variable. Methods Contrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a preregistered conceptual hierarchy. Controlling for treatment-level confounds, a random effects meta-analysis assessed the moderating effect of patient-therapist ratio on the alliance-outcome relationship in predefined single-predictor and multipredictor meta-regressions. Results The alliance-outcome relationship was found to be larger than previously thought (k = 28, N = 2,911, r = .29, 95% Confidence Interval 0.21, 0.37; p < .0001, I2 = 80%). When study samples exceeding the adolescent 12–19 age range were removed, the correlation rose (k = 15, N = 1,797, r = .34, 95% Confidence Interval 0.23, 0.45; p < .0001, I2 = 83%). In contrast to research with adults, patient-therapist ratio did not moderate this relationship in either single-predictor (p = .26) or multi-predictor (p = .22) models. Conclusions The alliance-outcome relationship for adolescents was larger than previously thought, and comparable to estimates in adult samples. The failure of patient-therapist ratio to moderate its strength, however, challenges the hypothesis that variability in therapist characteristics is an important determinant of the alliance-outcome effect in this age group. En ligne : http://dx.doi.org/10.1111/jcpp.12767 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=327
in Journal of Child Psychology and Psychiatry > 59-1 (January 2018) . - p.5-19[article] Practitioner Review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta-analysis [Texte imprimé et/ou numérique] / Regina MURPHY, Auteur ; Paul HUTTON, Auteur . - p.5-19.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 59-1 (January 2018) . - p.5-19
Mots-clés : Alliance alliance-outcome relationship adolescent therapy therapist variability meta-analysis Index. décimale : PER Périodiques Résumé : Background Previous meta-analyses have only found small correlations (r = .10 to r = .19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study-level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta-analysis aimed to address this gap by using patient-therapist ratio as a moderator variable. Methods Contrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a preregistered conceptual hierarchy. Controlling for treatment-level confounds, a random effects meta-analysis assessed the moderating effect of patient-therapist ratio on the alliance-outcome relationship in predefined single-predictor and multipredictor meta-regressions. Results The alliance-outcome relationship was found to be larger than previously thought (k = 28, N = 2,911, r = .29, 95% Confidence Interval 0.21, 0.37; p < .0001, I2 = 80%). When study samples exceeding the adolescent 12–19 age range were removed, the correlation rose (k = 15, N = 1,797, r = .34, 95% Confidence Interval 0.23, 0.45; p < .0001, I2 = 83%). In contrast to research with adults, patient-therapist ratio did not moderate this relationship in either single-predictor (p = .26) or multi-predictor (p = .22) models. Conclusions The alliance-outcome relationship for adolescents was larger than previously thought, and comparable to estimates in adult samples. The failure of patient-therapist ratio to moderate its strength, however, challenges the hypothesis that variability in therapist characteristics is an important determinant of the alliance-outcome effect in this age group. En ligne : http://dx.doi.org/10.1111/jcpp.12767 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=327 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)
[article]
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
in Journal of Child Psychology and Psychiatry > 57-5 (May 2016) . - p.625-632[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 The therapeutic alliance in cognitive-behavioral therapy for school-aged children with autism and clinical anxiety / S. M. KLEBANOFF in Autism, 23-8 (November 2019)
[article]
Titre : The therapeutic alliance in cognitive-behavioral therapy for school-aged children with autism and clinical anxiety Type de document : Texte imprimé et/ou numérique Auteurs : S. M. KLEBANOFF, Auteur ; K. A. ROSENAU, Auteur ; J. J. WOOD, Auteur Article en page(s) : p.2031-2042 Langues : Anglais (eng) Mots-clés : alliance anxiety autism cognitive behavioral therapy predictors of treatment outcome Index. décimale : PER Périodiques Résumé : Little is known about the alliance between therapists and children with autism spectrum disorder who are receiving psychological therapies in outpatient treatment settings. This study examined the therapeutic alliance in children with autism spectrum disorder and clinical anxiety, who were receiving cognitive behavioral therapy in a randomized, controlled trial. The Therapeutic Alliance Scale for Children was administered to a sample of children and youth with autism spectrum disorder and anxiety (N = 64; aged 7-14) as well as to their parents and therapists. A comparison sample of typically developing youth with clinical anxiety (N = 36; aged 5-12) was included. The child-therapist alliance was more positive among typically developing children than among children with autism spectrum disorder; correspondingly, the parent-therapist alliance was also more positive among parents of typically developing children. Therapist reports of positive child-therapist alliance predicted post-treatment reductions in anxiety among children with autism spectrum disorder, although child reports of this alliance did not. Parent reports of positive parent-therapist alliance also predicted post-treatment reductions in the child's anxiety in the group with autism spectrum disorder. A strong therapeutic alliance appears to be associated with better treatment outcomes in children with autism spectrum disorder receiving cognitive behavioral therapy, although a thoughtful and diagnostically sensitive approach is advisable to promote a positive alliance with children with autism spectrum disorder. En ligne : http://dx.doi.org/10.1177/1362361319841197 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=407
in Autism > 23-8 (November 2019) . - p.2031-2042[article] The therapeutic alliance in cognitive-behavioral therapy for school-aged children with autism and clinical anxiety [Texte imprimé et/ou numérique] / S. M. KLEBANOFF, Auteur ; K. A. ROSENAU, Auteur ; J. J. WOOD, Auteur . - p.2031-2042.
Langues : Anglais (eng)
in Autism > 23-8 (November 2019) . - p.2031-2042
Mots-clés : alliance anxiety autism cognitive behavioral therapy predictors of treatment outcome Index. décimale : PER Périodiques Résumé : Little is known about the alliance between therapists and children with autism spectrum disorder who are receiving psychological therapies in outpatient treatment settings. This study examined the therapeutic alliance in children with autism spectrum disorder and clinical anxiety, who were receiving cognitive behavioral therapy in a randomized, controlled trial. The Therapeutic Alliance Scale for Children was administered to a sample of children and youth with autism spectrum disorder and anxiety (N = 64; aged 7-14) as well as to their parents and therapists. A comparison sample of typically developing youth with clinical anxiety (N = 36; aged 5-12) was included. The child-therapist alliance was more positive among typically developing children than among children with autism spectrum disorder; correspondingly, the parent-therapist alliance was also more positive among parents of typically developing children. Therapist reports of positive child-therapist alliance predicted post-treatment reductions in anxiety among children with autism spectrum disorder, although child reports of this alliance did not. Parent reports of positive parent-therapist alliance also predicted post-treatment reductions in the child's anxiety in the group with autism spectrum disorder. A strong therapeutic alliance appears to be associated with better treatment outcomes in children with autism spectrum disorder receiving cognitive behavioral therapy, although a thoughtful and diagnostically sensitive approach is advisable to promote a positive alliance with children with autism spectrum disorder. En ligne : http://dx.doi.org/10.1177/1362361319841197 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=407