Client characteristics as moderators of the relation between the therapeutic alliance and outcome in cognitive therapy for depression.
Client characteristics as moderators of the relation between the therapeutic alliance and outcome in cognitive therapy for depression.
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DOI：
10.1037/a0035994
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发表时间：
2014-04
影响因子：
5.9
通讯作者：
Webb CA
中科院分区：
文献类型：
--
作者：
Lorenzo-Luaces L;DeRubeis RJ;Webb CA
关于可识别客户子集之间联盟结果相关性的可变性，人们知之甚少。这个问题是在60名接受抑郁症认知治疗的客户中进行的，从样本中观察到联盟评分和随后的症状变化之间的总体相关性为0.23。我们研究了观察者评估版本的工作联盟问卷(WAI-O)与客户人口统计学、抑郁症特征、个性和其他临床特征之间的交互作用，以预测后续症状变化。在校正多次比较后，WAI-O与既往抑郁发作次数之间的交互作用，以及基线焦虑症状的严重程度，是症状变化的显著预测因素。当控制这两种交互作用时，先前抑郁发作的次数成为具有统计学意义的调节因素。该联盟预测了有0-2次发作的客户子组的结果(r=.52)，但不预测有3次或更多发作的客户(r=−.02)的结果。尽管联盟上的单变量分布和两个亚组中的症状变化相似，但仍获得了这些发现。在联盟与结果的预测关系中观察到的差异作为先前发病次数的函数，表明不同的治疗过程可能解释了这些亚组的变化。如果本研究中观察到的模式被复制，这将表明联盟与结果的关联被低估和高估。
Little is known about the variability of the alliance-outcome correlation across identifiable client subsets. This question was explored in a sample of 60 clients receiving cognitive therapy for depression, from which an overall correlation of .23 was observed between alliance ratings and subsequent symptom change. We examined interactions between the observer-rated version of the Working Alliance Inventory (WAI-O) and client demographics, features of depression, personality and other clinical features in predicting subsequent symptom change. After correcting for multiple comparisons, interactions between the WAI-O and the number of prior depressive episodes, as well as the severity of baseline anxiety symptoms, were significant predictors of symptom change. When both interactions were controlled for, number of prior depressive episodes emerged as a statistically significant moderator. The alliance predicted outcome in the subgroup of clients with 0–2 prior episodes (r = .52), but not in those with 3 or more prior episodes (r = −.02). These findings were obtained despite similar univariate distributions on the alliance and symptom change in the two subgroups. Differences that were observed in the predictive relation of alliance to outcome as a function of number of prior episodes suggests that different therapy processes may account for change in these subgroups. If the pattern observed in the present study is replicated, it would suggest that the alliance-outcome association has been both under- and over-estimated.
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影响因子：
5.4
作者：
Hayes, Andrew F.;Matthes, Joerg
通讯作者：
Matthes, Joerg
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
--
作者：
DeRubeis, RJ;Hollon, SD;Gallop, R
通讯作者：
Gallop, R
影响因子：
2.5
作者：
Castonguay, Louis G.;Constantino, Michael J.;Holtforth, Martin Grosse
通讯作者：
Holtforth, Martin Grosse
影响因子：
3.7
作者：
DeRubeis RJ;Cohen ZD;Forand NR;Fournier JC;Gelfand LA;Lorenzo-Luaces L
通讯作者：
Lorenzo-Luaces L