The associations among improvement and alliance expectations, alliance during treatment, and treatment outcome for major depressive disorder

被引:48
作者
Barber, Jacques P. [1 ]
Zilcha-Mano, Sigal [1 ]
Gallop, Robert [2 ]
Barrett, Marna [3 ]
McCarthy, Kevin S. [4 ]
Dinger, Ulrike [1 ,5 ]
机构
[1] Adelphi Univ, Derner Inst, Garden City, NY 11530 USA
[2] W Chester Univ, W Chester, PA 19380 USA
[3] Univ Penn, Philadelphia, PA 19104 USA
[4] Chestnut Hill Coll, Dept Psychol, Philadelphia, PA USA
[5] Heidelberg Univ, Clin Gen Internal Med & Psychosomat, D-69115 Heidelberg, Germany
关键词
psychodynamic psychotherapy; medication; depression; expectation; alliance; placebo; COLLABORATIVE RESEARCH-PROGRAM; COGNITIVE-BEHAVIORAL THERAPY; MENTAL-HEALTH TREATMENT; WORKING ALLIANCE; INTERPERSONAL PROBLEMS; DYNAMIC PSYCHOTHERAPY; NATIONAL INSTITUTE; NIMH TREATMENT; PATIENT; ATTACHMENT;
D O I
10.1080/10503307.2013.871080
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Objective: To examine the associations between treatment/outcome expectations, alliance before and during treatment, and the impact of alliance on symptomatic improvement. Methods: One hundred and fifty-three depressed patients randomized to dynamic supportive-expressive psychotherapy (SET), antidepressant medication (ADM) or placebo (PBO) + clinical management completed ratings of treatment expectations, therapeutic alliance (CALPAS, WAI-S), and depressive symptoms (HAM-D). Results: Pretreatment expectations of the therapeutic alliance were significantly related to alliance later in therapy but did not differ across treatments and did not predict outcome. Alliance development over time differed between treatments; it increased more in SET than in PBO. After controlling for prior symptom improvement, early alliance predicted subsequent depression change. Conclusions: Expectations of alliance and of treatment outcome/improvement, measured prior to treatment onset, predicted subsequent alliance.
引用
收藏
页码:257 / 268
页数:12
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