Andreea Vîslă1,2, Michael J Constantino3, Katie Newkirk3, John S Ogrodniczuk4, Ingrid Söchting5. 1. a Department of Psychology , University of Zurich , Zurich , Switzerland. 2. b Department of Educational Sciences , Stefan cel Mare University of Suceava , Suceava , Romania. 3. c Department of Psychological and Brain Sciences , University of Massachusetts Amherst , Amherst , MA , USA. 4. d Department of Psychiatry , University of British Columbia , Vancouver , Canada. 5. e Department of Psychology , University of British Columbia , Vancouver , Canada.
Abstract
OBJECTIVE: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy. METHOD: This study focused on such associative chains among 91 depressed outpatients who completed 10 weeks of group cognitive-behavioral therapy. We conducted simple and multiple mediation analyses, accounting for the nested data structure. RESULTS: As predicted, we found: (i) The relations between baseline outcome expectation and both posttreatment anxiety and depression were mediated by alliance quality; (ii) the early therapy outcome expectation-posttreatment anxiety relation was mediated by mid-treatment alliance; (iii) the relation between early alliance and posttreatment interpersonal problems was mediated by during-therapy outcome expectation; and (iv) the relation between baseline outcome expectation and posttreatment interpersonal problems was mediated by two variables acting in turn, early alliance and during-therapy outcome expectation. All other tested models were not significant. CONCLUSIONS: Results suggest that bidirectional relations between outcome expectation and alliance, with both directions influencing outcome. Clinical and empirical implications are discussed.
OBJECTIVE: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy. METHOD: This study focused on such associative chains among 91 depressed outpatients who completed 10 weeks of group cognitive-behavioral therapy. We conducted simple and multiple mediation analyses, accounting for the nested data structure. RESULTS: As predicted, we found: (i) The relations between baseline outcome expectation and both posttreatment anxiety and depression were mediated by alliance quality; (ii) the early therapy outcome expectation-posttreatment anxiety relation was mediated by mid-treatment alliance; (iii) the relation between early alliance and posttreatment interpersonal problems was mediated by during-therapy outcome expectation; and (iv) the relation between baseline outcome expectation and posttreatment interpersonal problems was mediated by two variables acting in turn, early alliance and during-therapy outcome expectation. All other tested models were not significant. CONCLUSIONS: Results suggest that bidirectional relations between outcome expectation and alliance, with both directions influencing outcome. Clinical and empirical implications are discussed.
Entities:
Keywords:
alliance; depression; group CBT; mediation; outcome; outcome expectation
Authors: Jacob S Aday; Boris D Heifets; Steven D Pratscher; Ellen Bradley; Raymond Rosen; Joshua D Woolley Journal: Psychopharmacology (Berl) Date: 2022-04-01 Impact factor: 4.530
Authors: Dianne Wilson; Shylie Mackintosh; Michael K Nicholas; G Lorimer Moseley; Daniel S J Costa; Claire E Ashton-James Journal: Br J Pain Date: 2019-12-30
Authors: Paul N Pfeiffer; Kara Zivin; Avinash Hosanagar; Vanessa Panaite; Dara Ganoczy; H Myra Kim; Timothy Hofer; John D Piette Journal: J Behav Health Serv Res Date: 2022-10-07 Impact factor: 1.475
Authors: Alexander Miloff; Per Carlbring; William Hamilton; Gerhard Andersson; Lena Reuterskiöld; Philip Lindner Journal: J Med Internet Res Date: 2020-03-24 Impact factor: 5.428