Abstract:
OBJECTIVE:To better understand the role of therapeutic alliance in posttraumatic stress disorder (PTSD) treatment, we examined patterns of and shifts in alliance. First, we identified individuals with repaired ruptures, unrepaired ruptures, and no ruptures in alliance. Then, we explored group differences in these alliance events for clients with common clinical correlates (i.e., co-occurring depression and childhood abuse history) and whether or not the presence of these events influenced treatment outcome. METHOD:At pretreatment, clients (N = 116)-76.1% female, 66% Caucasian, age M = 36.7 years (SD = 11.3)--completed measures assessing PTSD diagnosis and severity (PTSD Symptom Scale Interview and Self-Report), depression diagnosis and severity (Structured Clinical Interview for DSM-IV and Beck Depression Inventory), and trauma history. During 10 weeks of prolonged exposure therapy, alliance (California Psychotherapy Alliance Scale) measures were completed. At posttreatment, PTSD and depression were reassessed. RESULTS:Ruptures in alliance were quite common (46%). No significant differences emerged in the frequency of repaired ruptures, unrepaired ruptures, or no ruptures between those with and without co-occurring major depressive disorder, χ²(2, N = 82) = 2.69, p = .26, or those with and without a history of childhood abuse, χ²(2, N = 81) = 0.57, p = .75. Unrepaired ruptures predicted worse treatment outcome (β = .44, p = .001). CONCLUSIONS:The current study underscores the importance of attending to discontinuities in alliance throughout treatment.
journal_name
J Consult Clin Psycholjournal_title
Journal of consulting and clinical psychologyauthors
McLaughlin AA,Keller SM,Feeny NC,Youngstrom EA,Zoellner LAdoi
10.1037/a0034696subject
Has Abstractpub_date
2014-02-01 00:00:00pages
112-21issue
1eissn
0022-006Xissn
1939-2117pii
2013-38688-001journal_volume
82pub_type
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journal_title:Journal of consulting and clinical psychology
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journal_title:Journal of consulting and clinical psychology
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