Therapist competence and therapeutic alliance are important in the treatment of health anxiety (hypochondriasis)
Therapist competence and therapeutic alliance are important in the treatment of health anxiety (hypochondriasis)
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治疗师的能力和治疗联盟对于健康焦虑（疑病症）的治疗很重要
DOI：
10.1016/j.psychres.2015.03.042
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发表时间：
2015
影响因子：
11.3
通讯作者：
Höfling
中科院分区：
文献类型：
--
作者：
Richtberg;J. M. B. ;Höfling
治疗传递因素的作用（即，治疗师依从性、治疗师能力和治疗联盟）在健康焦虑的心理治疗中很少被调查。本研究旨在探讨评估视角在评估治疗实施因素中的作用及其与治疗结果的相关性。治疗师的依从性，治疗师的能力，和治疗联盟进行了评估，由独立的评分，治疗师，患者和监督员在68个治疗。对重度健康焦虑（抑郁症）患者进行认知疗法或暴露疗法治疗。治疗结果由独立的诊断专家进行标准化访谈进行评估。多特质多方法分析显示，治疗师的依从性，治疗师的能力，和治疗联盟的评估角度有很大的影响。评估者的观点是最重要的治疗结果的预测。治疗联盟和治疗师能力可解释治疗结果的6%的方差，而治疗师依从性与治疗结果无关。治疗师能力与治疗结果仅间接相关，由治疗联盟介导。治疗联盟和治疗师能力是影响健康焦虑心理治疗效果的重要因素。在健康焦虑的心理治疗过程中，对这些过程的更强有力的考虑可能能够改善心理治疗的结果。
The role of treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) is rarely investigated in psychotherapeutic treatment for health anxiety. This study aimed to investigate the role of the assessment perspective for the evaluation of treatment delivery factors and their relevance for treatment outcome. Therapist adherence, therapist competence, and therapeutic alliance were evaluated by independent raters, therapists, patients, and supervisors in 68 treatments. Patients with severe health anxiety (hypochondriasis) were treated with cognitive therapy or exposure therapy. Treatment outcome was assessed with a standardized interview by independent diagnosticians. A multitrait–multimethod analysis revealed a large effect for the assessment perspective of therapist adherence, therapist competence, and therapeutic alliance. The rater perspective was the most important for the prediction of treatment outcome. Therapeutic alliance and therapist competence accounted for 6% of the variance of treatment outcome while therapist adherence was not associated with treatment outcome. Therapist competence was only indirectly associated with treatment outcome, mediated by therapeutic alliance. Both therapeutic alliance and therapist competence demonstrated to be important treatment delivery factors in psychotherapy for health anxiety. A stronger consideration of those processes during psychotherapy for health anxiety might be able to improve psychotherapy outcome.
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