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Therapists’ perceptions of interpersonally challenging patients in generalized anxiety disorder
Psychotherapy Research ( IF 4.117 ) Pub Date : 2022-04-21 , DOI: 10.1080/10503307.2022.2062268
Juan Martín Gómez Penedo 1 , Christoph Flückiger 2
Affiliation  

ABSTRACT

Objective:

This study explores in cognitive-behavioral therapy (CBT) for generalized anxiety disorder (GAD) to what degree therapists’ perceptions of their patients as interpersonally challenging (IC) is explained by the therapist or patient effects, if baseline patients’ characteristics predict IC, and if IC is related to outcome.

Method:

Eighty patients diagnosed with GAD and treated by 20 therapists with 16 sessions of CBT were randomized to two different implementation conditions. Patients completed baseline measures of depression, anxiety, interpersonal problems, and interpersonal strengths. The therapists completed a single-item assessing IC session-by-session. As an outcome, patients completed a worry measure at baseline, session 5, session 10, and posttreatment.

Results:

Multilevel models showed meaningful therapist effects, explaining 18% of IC variance. Interpersonal strengths were the only baseline predictor significantly and negatively associated with IC during treatment. Structural equation models showed significant negative IC effects on subsequent patient worry during therapy.

Conclusions:

IC might represent a risk factor for psychotherapy outcome. Patient interpersonal strengths at baseline may buffer therapists perceiving their patients as ICs. The therapist effects on IC suggest that CBT clinicians treating GAD might benefit from identifying cases that are interpersonally challenging for them and reflecting about what might trigger that perception.



中文翻译:

治疗师对广泛性焦虑症患者的人际关系挑战的看法

摘要

客观的:

本研究探讨了广泛性焦虑症 (GAD) 的认知行为疗法 (CBT) 在多大程度上治疗师对患者的人际挑战 (IC) 的看法可以通过治疗师或患者的效果来解释,如果基线患者的特征预测 IC,如果 IC 与结果有关。

方法:

80 名被诊断患有 GAD 并由 20 名治疗师进行 16 次 CBT 治疗的患者被随机分配到两种不同的实施条件。患者完成了抑郁、焦虑、人际关系问题和人际关系优势的基线测量。治疗师完成了一项逐次评估 IC 的单项评估。结果,患者在基线、第 5 期、第 10 期和治疗后完成了一项担忧测量。

结果:

多级模型显示了有意义的治疗师效果,解释了 18% 的 IC 方差。人际交往能力是治疗期间与 IC 显着和负相关的唯一基线预测因子。结构方程模型显示出对治疗期间后续患者担忧的显着负面 IC 影响。

结论:

IC 可能代表心理治疗结果的风险因素。基线时的患者人际关系强度可能会缓冲治疗师将他们的患者视为 IC。治疗师对 IC 的影响表明,治疗 GAD 的 CBT 临床医生可能会受益于识别对他们来说具有人际挑战的病例并反思可能引发这种看法的原因。

更新日期:2022-04-22
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