Psychotherapeutic competence and adherence: Importance for the treatment of panic disorder with agoraphobia

惊恐障碍与广场恐怖症是伴随着严重的损害和负担的病人，是一个心理障碍与高成本。暴露疗法是一种非常有效的，经过试验和测试的治疗形式，其中暴露的成功实施与积极的治疗结果有关。然而，人们对治疗中的因素如何有助于成功的暴露过程知之甚少。我们相信，在准备暴露的过程中，治疗师起着核心作用。目前的研究目的是有两个独立的评级评估的坚持和能力的治疗师在准备阶段暴露在84治疗惊恐障碍与广场恐怖症。这些治疗师特征将用于预测治疗结果，一方面通过自我评估问卷（广场恐惧症焦虑、惊恐发作和回避行为）进行量化，另一方面通过行为回避测试（足以激发广场恐惧症焦虑的标准化情况）期间的客观行为观察进行量化。除了治疗师的特征（依从性和能力），患者的特征（社会人口统计学和精神病理学特征和互动行为）和治疗关系的质量（由两名独立评估者评估）也被考虑用于预测治疗结果。计划研究的基础是一项多中心随机对照试验，其中120名患有惊恐障碍伴广场恐怖症的患者接受了手动暴露疗法治疗。

Panic disorder with agoraphobia is accompanied by serious impairments and burdens for the patient and is one of the psychological disorders associated with high costs. Exposure therapy is a highly effective, tried and tested treatment form, in which the successful implementation of exposure is connected to positive treatment outcome. However, little is known about how the factors within the treatment contribute to a successful course of the exposure. We believe that, during the preparation of exposure, the therapist plays a central role. The current research intention is to have two independent raters assess the adherence and competence of therapists during the preparation phase for exposure in 84 treatments of panic disorder with agoraphobia. These therapist characteristics are to be used for the prediction of treatment outcome, which is quantified on the one hand with self-assessment questionnaires (agoraphobic anxiety, panic attacks, and avoidance behavior) and on the other hand with objective behavior observations during the Behavioral Avoidance Test (a standardized situation that is adequate for the provocation of agoraphobic anxiety). Next to characteristics of the therapist (adherence and competence), characteristics of the patient (sociodemographic and psychopathological characteristics and interaction behavior) and the quality of the therapeutic relationship (assessed by two further independent raters) are to be considered for the prediction of treatment outcome. The basis for the planned study is a multicenter randomized controlled trial, in which 120 patients suffering from panic disorder with agoraphobia were treated with manualized exposure therapy.