Merzhvynska, M., Simmonds-Buckley, M., Delgadillo, J. et al. (1 more author) (2021) Trajectories of change in the therapeutic alliance during Cognitive Analytic Therapy for depression. Psychology and Psychotherapy: Theory, Research and Practice, 94 (3). pp. 464-480. ISSN 1476-0835
Abstract
BACKGROUND: Managing the alliance is considered to be a core competency and central therapeutic change process during cognitive analytic therapy (CAT). This study examined latent trajectories of change in the alliance and their relationship to depression treatment outcomes. DESIGN: Secondary analysis of a randomized controlled trial.
METHODS: A sample of N = 79 depressed participants completed standardized alliance (WAI-SF) and depression symptom measures (PHQ-9) every session during an 8-session CAT intervention. Growth mixture modelling was applied to model alliance trajectories and to classify cases into different latent classes. Associations between alliance class and post-treatment PHQ-9 scores were examined using hierarchical linear regression, controlling for confounders.
RESULTS: There were two classes of alliance trajectories. The majority class (91%) displayed stable alliance trajectories, whilst a minority class (9%) had initially poor alliance ratings that significantly improved during treatment. Baseline severity and early change in depression symptoms significantly predicted treatment outcomes, but early alliance and longitudinal alliance change did not.
CONCLUSIONS: Alliance trajectories did not significantly predict depression treatment outcomes after controlling for initial symptom severity and early change. An important limitation concerns the small sample size, so future replication in larger samples is necessary.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 British Psychological Society. This is an author-produced version of a paper subsequently published in Psychology and Psychotherapy. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | alliance; cognitive analytic therapy; depression; early response |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Science (Sheffield) > Department of Psychology (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 21 Jan 2021 09:30 |
Last Modified: | 10 Feb 2022 16:43 |
Published Version: | https://bpspsychub.onlinelibrary.wiley.com/doi/ful... |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/papt.12322 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:170312 |