Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients
Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients
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DOI：
10.1002/cpp.2352
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发表时间：
2019-05-01
影响因子：
3.6
通讯作者：
van der Lee, Marije L.
中科院分区：
文献类型：
--
作者：
Bisseling, Else M.;Schellekens, Melanie P. J.;van der Lee, Marije L.
基于正念的认知疗法（MBCT）是精神和躯体保健领域的一种创新的循证干预措施。了解与治疗结果相关的治疗因素可以改善 MBCT。本研究重点关注癌症患者 MBCT 治疗结果的预测因素，并检验团体凝聚力、治疗联盟和治疗师能力是否可以预测癌症患者 MBCT 后心理困扰的减少。此外，还检查了治疗师的能力是否促进了治疗联盟或团体凝聚力。对在一项更大的随机对照试验中收集的患者子样本进行了多水平分析，这些试验涉及个体基于互联网的 MBCT 与基于团体的 MBCT 以及对痛苦的癌症患者的常规治疗。当前的分析包括 120 名随机接受基于小组的 MBCT 患者中的 84 名完成了基于小组的 MBCT 患者。团体凝聚力和治疗师能力并不能预测心理困扰的减少，而治疗联盟则可以。此外，治疗师的能力并不能预测治疗联盟，而是与团体凝聚力降低有关。我们的研究结果表明，治疗联盟显着有助于减少癌症患者 MBCT 中的心理困扰。阐述治疗联盟预测意义的临床意义可能对增强 MBCT 的潜在效果具有附加价值。
Mindfulness-based cognitive therapy (MBCT) is an innovative evidence-based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet-based versus group-based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group-based MBCT out of 120 patients who were randomized to group-based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.