Abstract

Objective:

This study examines relationships among different aspects of therapeutic alliance with treatment outcome, adherence and attrition in internet delivered cognitive behavioral therapy (ICBT) for panic disorder.

Methods:

We examined alliance-outcome relationships in ICBT (N = 74) using a newly developed self-report alliance measure that disentangles alliance with program content (Internet Patient’s Experience of Attunement and Responsiveness with the program; I-PEARp) and with the therapist (I-PEARt). We compared ICBT outcomes of patient rated and therapist-rated alliance with conventional alliance scales (WAI-6 and WAI-T).

Results:

Consistent with our hypothesis, I-PEARp and I-PEARt distinguished between different aspects of the alliance and predicted outcomes better than standard alliance scales. Furthermore, higher ratings of I-PEARp were associated with subsequent lower symptoms and lower symptoms were associated with higher subsequent alliance. In contrast, I-PEARt predicted adherence, but not symptoms. Although therapists’ ratings of alliance (thI-PEAR) improved significantly during treatment, they did not predict subsequent symptoms, adherence, or dropout.

Conclusion:

Results indicate that the patient experience of the alliance in ICBT includes two aspects, each of which uniquely contributes to outcomes; patient connection to the program is related to symptom outcomes whereas the dyadic relationship with the therapist serves as the glue to allow the treatment to hold.

中文翻译：

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与该计划的患者联盟可预测治疗结果，而与治疗师的联盟可预测基于互联网的恐慌症治疗的依从性

摘要

客观的：

本研究调查了治疗联盟的不同方面与恐慌症的互联网交付认知行为疗法 (ICBT) 的治疗结果、依从性和损耗之间的关系。

方法：

我们 使用新开发的自我报告联盟措施检查了 ICBT 中的联盟-结果关系（N = 74），该衡量标准将联盟与计划内容（互联网患者对程序的协调和反应体验；I-PEARp）和治疗师（I -梨）。我们将患者评分和治疗师评分联盟的 ICBT 结果与传统联盟量表（WAI-6 和 WAI-T）进行了比较。

结果：

与我们的假设一致，I-PEARp 和 I-PEARt 区分了联盟的不同方面，并且比标准联盟量表更好地预测结果。此外，I-PEARp 的较高评级与随后的较低症状相关，而较低的症状与较高的后续联盟相关。相比之下，I-PEARt 可预测依从性，但不能预测症状。尽管治疗师的联盟 (thI-PEAR) 评级在治疗期间显着提高，但他们并没有预测随后的症状、依从性或退出。

结论：

结果表明，ICBT 联盟的患者体验包括两个方面，每个方面都对结果有独特的贡献；患者与该计划的联系与症状结果有关，而与治疗师的二元关系则是使治疗得以持续的粘合剂。