TY - JOUR
T1 - Agreement in patient-therapist alliance ratings and its relation to dropout and outcome in a large sample of cognitive behavioral therapy for panic disorder
AU - Moshe-Cohen, Rotem
AU - Kivity, Yogev
AU - Huppert, Jonathan D.
AU - Barlow, David H.
AU - Gorman, Jack M.
AU - Shear, Katherine
AU - Woods, Scott W.
N1 - Publisher Copyright:
© 2022 Society for Psychotherapy Research.
PY - 2024
Y1 - 2024
N2 - Objective: The therapeutic alliance is related to treatment outcome but less is known about the agreement on alliance between patients and therapists and its relationship to outcomes. We examined the association of patient-therapist congruence of alliance perceptions, early and late in cognitive behavioral therapy for panic disorder in relation to symptom reduction and dropout. Method: Patients (n = 181) and their therapists provided alliance ratings early and late during 11-session treatment. Independent evaluators rated patients’ symptomatic levels post-treatment. Polynomial regression and response surface analysis were used to examine congruence as a predictor of outcome. Results: Early in therapy, stronger combined patient-therapist alliances, regardless of agreement, predicted lower symptom severity at the end of therapy and a lower likelihood of dropout. Late in treatment, the outcome was worse when therapist ratings of the alliance were higher than those of the patient. Conclusions: Therapist-patient agreement on the strength of the alliance is important for symptom improvement and dropout. The study highlights the importance of understanding the dyadic nature of the alliance and its impact on therapeutic change.
AB - Objective: The therapeutic alliance is related to treatment outcome but less is known about the agreement on alliance between patients and therapists and its relationship to outcomes. We examined the association of patient-therapist congruence of alliance perceptions, early and late in cognitive behavioral therapy for panic disorder in relation to symptom reduction and dropout. Method: Patients (n = 181) and their therapists provided alliance ratings early and late during 11-session treatment. Independent evaluators rated patients’ symptomatic levels post-treatment. Polynomial regression and response surface analysis were used to examine congruence as a predictor of outcome. Results: Early in therapy, stronger combined patient-therapist alliances, regardless of agreement, predicted lower symptom severity at the end of therapy and a lower likelihood of dropout. Late in treatment, the outcome was worse when therapist ratings of the alliance were higher than those of the patient. Conclusions: Therapist-patient agreement on the strength of the alliance is important for symptom improvement and dropout. The study highlights the importance of understanding the dyadic nature of the alliance and its impact on therapeutic change.
KW - alliance
KW - anxiety
KW - cognitive behavior therapy
UR - http://www.scopus.com/inward/record.url?scp=85141097293&partnerID=8YFLogxK
U2 - 10.1080/10503307.2022.2124131
DO - 10.1080/10503307.2022.2124131
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 36169615
AN - SCOPUS:85141097293
SN - 1050-3307
VL - 34
SP - 28
EP - 40
JO - Psychotherapy Research
JF - Psychotherapy Research
IS - 1
ER -