Sigal Zilcha-Mano1, Ulrike Dinger2, Kevin S McCarthy3, Jacques P Barber1. 1. Derner Institute of Advanced Psychological Studies, Adelphi University. 2. Clinic for General Internal Medicine and Psychosomatics, University of Heidelberg. 3. Department of Psychology, Chestnut Hill College.
Abstract
OBJECTIVE: Scholars increasingly recognize that therapeutic alliance and symptomatic change are associated with one another. A common assumption is that alliance predicts symptomatic change. However, the issue is far from settled. One challenge in determining the causality is the establishment of temporal precedence showing that alliance, as opposed to previous symptomatic change, drives subsequent symptomatic reduction. METHOD: To make further advances in untangling this chicken-and-egg question, we employed autoregressive cross-lagged modeling over 4 time points in a sample of 149 depressive patients receivingsupportive-expressive psychotherapy or clinical management combined with pharmacotherapy or clinical management combined with placebo. RESULTS: Using this methodology, we found that both alliance and symptoms across treatment made significant and unique contributions in predicting subsequent symptomatic levels throughout treatment. Additionally, alliance, but not symptoms, predicted subsequent alliance levels. No differences were found between treatments. CONCLUSIONS: Our findings imply that alliance temporally precedes symptomatic levels throughout treatment.
RCT Entities:
OBJECTIVE: Scholars increasingly recognize that therapeutic alliance and symptomatic change are associated with one another. A common assumption is that alliance predicts symptomatic change. However, the issue is far from settled. One challenge in determining the causality is the establishment of temporal precedence showing that alliance, as opposed to previous symptomatic change, drives subsequent symptomatic reduction. METHOD: To make further advances in untangling this chicken-and-egg question, we employed autoregressive cross-lagged modeling over 4 time points in a sample of 149 depressivepatients receiving supportive-expressive psychotherapy or clinical management combined with pharmacotherapy or clinical management combined with placebo. RESULTS: Using this methodology, we found that both alliance and symptoms across treatment made significant and unique contributions in predicting subsequent symptomatic levels throughout treatment. Additionally, alliance, but not symptoms, predicted subsequent alliance levels. No differences were found between treatments. CONCLUSIONS: Our findings imply that alliance temporally precedes symptomatic levels throughout treatment.
Authors: Paul Crits-Christoph; Mary Beth Connolly Gibbons; Jessica Hamilton; Sarah Ring-Kurtz; Robert Gallop Journal: J Consult Clin Psychol Date: 2011-06
Authors: Sigal Zilcha-Mano; Ulrike Dinger; Kevin S McCarthy; Marna S Barrett; Jacques P Barber Journal: J Affect Disord Date: 2013-10-16 Impact factor: 4.839
Authors: Sigal Zilcha-Mano; Ulrike Dinger; Kevin S McCarthy; Marna S Barrett; Jacques P Barber Journal: J Affect Disord Date: 2013-10-16 Impact factor: 4.839
Authors: Sigal Zilcha-Mano; J Christopher Muran; Clara Hungr; Catherine F Eubanks; Jeremy D Safran; Arnold Winston Journal: J Consult Clin Psychol Date: 2016-04-07
Authors: Sigal Zilcha-Mano; Kevin S McCarthy; Ulrike Dinger; Dianne L Chambless; Barbara L Milrod; Lauren Kunik; Jacques P Barber Journal: J Consult Clin Psychol Date: 2015-06-01
Authors: Erin C Accurso; Ellen E Fitzsimmons-Craft; Anna Ciao; Li Cao; Ross D Crosby; Tracey L Smith; Marjorie H Klein; James E Mitchell; Scott J Crow; Stephen A Wonderlich; Carol B Peterson Journal: J Consult Clin Psychol Date: 2015-04-20
Authors: Sigal Zilcha-Mano; Harold Chui; Tohar Dolev; Kevin S McCarthy; Ulrike Dinger; Jacques P Barber Journal: J Affect Disord Date: 2015-12-31 Impact factor: 4.839