Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents
Background: Caregivers play a key role in the success of trauma-focused cognitive behavioural therapy (TF-CBT). Yet, the effect of their alliance on treatment outcomes besides the other parties in treatment has hardly been studied. Objective: This study examined the working alliance (WA) of therapis...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-12-01
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| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20008198.2020.1753939 |
| _version_ | 1797954497132101632 |
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| author | S. Loos D. Tutus R. Kilian L. Goldbeck |
| author_facet | S. Loos D. Tutus R. Kilian L. Goldbeck |
| author_sort | S. Loos |
| collection | DOAJ |
| description | Background: Caregivers play a key role in the success of trauma-focused cognitive behavioural therapy (TF-CBT). Yet, the effect of their alliance on treatment outcomes besides the other parties in treatment has hardly been studied. Objective: This study examined the working alliance (WA) of therapists, patients and caregivers in TF-CBT and its contribution on treatment outcome over time. Methods: N = 76 children and adolescents (mean age = 12.66 years, range 7–17, M/F ratio: .43) participated in the TF-CBT arm of a randomized controlled trial. The WA was assessed with the Working Alliance Inventory Short Version (WAI-S) at two measurement points, while symptom level of posttraumatic stress symptoms (PTSS) was assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Paired sample t-tests, intraclass correlations (ICC), and mixed-effects regression models for longitudinal data were performed. Results: The alliance rating was high across all informants, with caregivers achieving the highest rating. The average level of cross-informant agreement on the alliance was low between therapists and caregivers (ICC = .26) and moderate between therapists and patients (ICC =.65). A significant contribution of an alliance improvement to the reduction of PTSS over time was found in each of the two tested models: therapists with patients model (b = .682) and therapists with caregivers model (b = .807). However, these effects were not detected with all four perspectives in one comprehensive model. Conclusion: In summary, the potential of caregivers’ views should receive more attention in the therapeutic process of trauma-focused therapy. |
| first_indexed | 2024-04-10T23:18:22Z |
| format | Article |
| id | doaj.art-0e2f002e5be545179a4a7afbac0d308c |
| institution | Directory Open Access Journal |
| issn | 2000-8066 |
| language | English |
| last_indexed | 2024-04-10T23:18:22Z |
| publishDate | 2020-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj.art-0e2f002e5be545179a4a7afbac0d308c2023-01-12T15:31:32ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662020-12-0111110.1080/20008198.2020.17539391753939Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescentsS. Loos0D. Tutus1R. Kilian2L. Goldbeck3University Clinic UlmUniversity Clinic UlmUniversity Clinic UlmUniversity Clinic UlmBackground: Caregivers play a key role in the success of trauma-focused cognitive behavioural therapy (TF-CBT). Yet, the effect of their alliance on treatment outcomes besides the other parties in treatment has hardly been studied. Objective: This study examined the working alliance (WA) of therapists, patients and caregivers in TF-CBT and its contribution on treatment outcome over time. Methods: N = 76 children and adolescents (mean age = 12.66 years, range 7–17, M/F ratio: .43) participated in the TF-CBT arm of a randomized controlled trial. The WA was assessed with the Working Alliance Inventory Short Version (WAI-S) at two measurement points, while symptom level of posttraumatic stress symptoms (PTSS) was assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Paired sample t-tests, intraclass correlations (ICC), and mixed-effects regression models for longitudinal data were performed. Results: The alliance rating was high across all informants, with caregivers achieving the highest rating. The average level of cross-informant agreement on the alliance was low between therapists and caregivers (ICC = .26) and moderate between therapists and patients (ICC =.65). A significant contribution of an alliance improvement to the reduction of PTSS over time was found in each of the two tested models: therapists with patients model (b = .682) and therapists with caregivers model (b = .807). However, these effects were not detected with all four perspectives in one comprehensive model. Conclusion: In summary, the potential of caregivers’ views should receive more attention in the therapeutic process of trauma-focused therapy.http://dx.doi.org/10.1080/20008198.2020.1753939children/adolescentsworking alliancetrauma-focused cognitive behavioural therapy (tf-cbt)posttraumatic stress symptoms (ptss)posttraumatic stress disorder (ptsd) |
| spellingShingle | S. Loos D. Tutus R. Kilian L. Goldbeck Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents European Journal of Psychotraumatology children/adolescents working alliance trauma-focused cognitive behavioural therapy (tf-cbt) posttraumatic stress symptoms (ptss) posttraumatic stress disorder (ptsd) |
| title | Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents |
| title_full | Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents |
| title_fullStr | Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents |
| title_full_unstemmed | Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents |
| title_short | Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents |
| title_sort | do caregivers perspectives matter working alliances and treatment outcomes in trauma focused cognitive behavioural therapy with children and adolescents |
| topic | children/adolescents working alliance trauma-focused cognitive behavioural therapy (tf-cbt) posttraumatic stress symptoms (ptss) posttraumatic stress disorder (ptsd) |
| url | http://dx.doi.org/10.1080/20008198.2020.1753939 |
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