Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder
ObjectiveTherapeutic alliance has consistently been found to predict treatment outcomes across various psychotherapies and patient diagnosis. However, the relationship between therapeutic alliance and outcome in Cognitive Behavioral Therapy (CBT) has shown mixed results. This study investigated the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.658693/full |
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| author | Nadja Wolf Patricia van Oppen Patricia van Oppen Adriaan W. Hoogendoorn Adriaan W. Hoogendoorn Anton J. L. M. van Balkom Anton J. L. M. van Balkom Henny A. D. Visser |
| author_facet | Nadja Wolf Patricia van Oppen Patricia van Oppen Adriaan W. Hoogendoorn Adriaan W. Hoogendoorn Anton J. L. M. van Balkom Anton J. L. M. van Balkom Henny A. D. Visser |
| author_sort | Nadja Wolf |
| collection | DOAJ |
| description | ObjectiveTherapeutic alliance has consistently been found to predict treatment outcomes across various psychotherapies and patient diagnosis. However, the relationship between therapeutic alliance and outcome in Cognitive Behavioral Therapy (CBT) has shown mixed results. This study investigated the impact of different aspects of therapeutic alliance in CBT for Obsessive-Compulsive Disorder (OCD).MethodData from two previously completed randomized controlled trials of 208 patients with OCD and their therapists were analyzed. Therapeutic alliance was assessed at week 4 of treatment with the patient-rated and therapist-rated Working Alliance Inventory (WAI), which includes three subscales to measure alliance domains (Goal, Task and Bond). Higher WAI score reflects a better therapeutic relationship. OCD severity was rated by independent assessors at baseline and post-treatment using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Linear regression analyses were used to examine the effects of the different aspects of therapeutic alliance on treatment outcome, adjusted for baseline symptom severity.ResultsA higher total WAI score as rated by therapists significantly predicted a lower post-treatment Y-BOCS. Further, higher scores on the Goal and Task subscales of the WAI were associated with lower post-treatment severity. However, these significant outcomes reflected only small effect sizes.ConclusionsIn the treatment of OCD, the strength of the therapeutic alliance contributes to outcomes, though to a limited extent. Effective OCD treatment involves the delivery of specific therapy interventions, in the context of a strong therapeutic alliance. |
| first_indexed | 2024-04-13T10:23:45Z |
| format | Article |
| id | doaj.art-34608de613d845ef85e2a85fbe1ea34a |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-13T10:23:45Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-34608de613d845ef85e2a85fbe1ea34a2022-12-22T02:50:23ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-03-011310.3389/fpsyt.2022.658693658693Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive DisorderNadja Wolf0Patricia van Oppen1Patricia van Oppen2Adriaan W. Hoogendoorn3Adriaan W. Hoogendoorn4Anton J. L. M. van Balkom5Anton J. L. M. van Balkom6Henny A. D. Visser7Mental Health Care Institute Geestelijke gezondheidszorg (GGZ) Centraal, Amersfoort, NetherlandsDepartment of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, NetherlandsGeestelijke Gezondheidszorg (GGZ) InGeest Specialized Mental Health Care, Amsterdam, NetherlandsDepartment of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, NetherlandsGeestelijke Gezondheidszorg (GGZ) InGeest Specialized Mental Health Care, Amsterdam, NetherlandsDepartment of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, NetherlandsGeestelijke Gezondheidszorg (GGZ) InGeest Specialized Mental Health Care, Amsterdam, NetherlandsMental Health Care Institute Geestelijke gezondheidszorg (GGZ) Centraal, Amersfoort, NetherlandsObjectiveTherapeutic alliance has consistently been found to predict treatment outcomes across various psychotherapies and patient diagnosis. However, the relationship between therapeutic alliance and outcome in Cognitive Behavioral Therapy (CBT) has shown mixed results. This study investigated the impact of different aspects of therapeutic alliance in CBT for Obsessive-Compulsive Disorder (OCD).MethodData from two previously completed randomized controlled trials of 208 patients with OCD and their therapists were analyzed. Therapeutic alliance was assessed at week 4 of treatment with the patient-rated and therapist-rated Working Alliance Inventory (WAI), which includes three subscales to measure alliance domains (Goal, Task and Bond). Higher WAI score reflects a better therapeutic relationship. OCD severity was rated by independent assessors at baseline and post-treatment using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Linear regression analyses were used to examine the effects of the different aspects of therapeutic alliance on treatment outcome, adjusted for baseline symptom severity.ResultsA higher total WAI score as rated by therapists significantly predicted a lower post-treatment Y-BOCS. Further, higher scores on the Goal and Task subscales of the WAI were associated with lower post-treatment severity. However, these significant outcomes reflected only small effect sizes.ConclusionsIn the treatment of OCD, the strength of the therapeutic alliance contributes to outcomes, though to a limited extent. Effective OCD treatment involves the delivery of specific therapy interventions, in the context of a strong therapeutic alliance.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.658693/fulltherapeutic allianceObsessive-Compulsive Disorder (OCD)psychotherapy outcomepredictorCognitive-Behavioral Therapy (CBT) |
| spellingShingle | Nadja Wolf Patricia van Oppen Patricia van Oppen Adriaan W. Hoogendoorn Adriaan W. Hoogendoorn Anton J. L. M. van Balkom Anton J. L. M. van Balkom Henny A. D. Visser Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder Frontiers in Psychiatry therapeutic alliance Obsessive-Compulsive Disorder (OCD) psychotherapy outcome predictor Cognitive-Behavioral Therapy (CBT) |
| title | Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder |
| title_full | Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder |
| title_fullStr | Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder |
| title_full_unstemmed | Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder |
| title_short | Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder |
| title_sort | therapeutic alliance and treatment outcome in cognitive behavior therapy for obsessive compulsive disorder |
| topic | therapeutic alliance Obsessive-Compulsive Disorder (OCD) psychotherapy outcome predictor Cognitive-Behavioral Therapy (CBT) |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.658693/full |
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