Abstract

Objective:

Identifying predictors of dropout is an important step in improving treatment outcomes. The alliance is the most frequently studied psychotherapy process variable, but its relation to dropout in cognitive behavioral therapy (CBT) of depression is not well understood.

Methods:

We evaluated the alliance at session one as reported by clients and therapists as predictors of dropout among 126 clients with major depressive disorder participating in CBT for depression.

Results:

Over a similar time period, those who dropped out experienced less symptom change than those who did not. Client, but not therapist reported alliance was related to reduced risk for dropout. This relation remained significant even when clients’ pre-treatment predictions of the alliance were included as a covariate. Concurrent use of medication did not moderate the alliance-dropout relation.

Conclusion:

Our findings are consistent with alliance being an important contributor to risk of dropout in CBT for depression. Future research should investigate intervention strategies that might promote the alliance as a means of reducing dropout.

中文翻译：

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抑郁症认知行为治疗中的治疗联盟与退出

摘要

客观的：

确定辍学的预测因素是改善治疗结果的重要一步。联盟是最常研究的心理治疗过程变量，但它与抑郁症认知行为治疗 (CBT) 中途退出的关系尚不清楚。

方法：

我们在第一次会议上评估了客户和治疗师报告的联盟，作为参与 CBT 治疗抑郁症的 126 名重度抑郁症客户中途退出的预测因素。

结果：

在相似的时间段内，那些退出的人比没有退出的人经历更少的症状变化。客户而非治疗师报告联盟与降低辍学风险有关。即使将客户对联盟的治疗前预测作为协变量包括在内，这种关系仍然很重要。同时使用药物并没有缓和联盟-辍学关系。

结论：

我们的研究结果与联盟是导致抑郁症 CBT 退出风险的重要因素一致。未来的研究应该调查可能促进联盟作为减少辍学手段的干预策略。