Effects of alliance ruptures and repairs on outcomes

Elke Humer; Elisabeth Schramm; Jan Philipp Klein; Martin Härter; Martin Hautzinger; Christoph Pieh; Thomas Probst

doi:10.1080/10503307.2021.1874070

Effects of alliance ruptures and repairs on outcomes

Elke Humer^*, Elisabeth Schramm, Jan Philipp Klein, Martin Härter, Martin Hautzinger, Christoph Pieh, Thomas Probst

^*Corresponding author for this work

Department of Psychiatry, Psychosomatics and Psychotherapie

9 Citations (Scopus)

Abstract

Objective: This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Method: Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP: 134; SP: 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients’ and therapists’ rating separately. Based on the reliable change in the HAQ from one session to the next categories were: no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome. Results: The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome: in the unrepaired rupture category, patients had higher HRSD-ratings across time points (p = 0.047). Conclusions: CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes. Trial registration:ClinicalTrials.gov identifier: NCT00970437.

Original language	English
Journal	Psychotherapy Research
Volume	31
Issue number	8
Pages (from-to)	977-987
Number of pages	11
ISSN	1050-3307
DOIs	https://doi.org/10.1080/10503307.2021.1874070
Publication status	Published - 2021

Funding

This study was funded by grants from the German Research Foundation (SCHR443/11-2, SCHN1204/3-1, and WA1539/4-1). The sponsor (German Research Foundation) has reviewed and approved the study protocol in the context of the grant application process. It had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The full study team consists of Levente Kriston, Ramona Meister; Hamburg-Eppendorf. Moritz Elsaesser, Thomas Fangmeier, Paul Bausch, Katharina Domschke, Mathias Berger; Freiburg. Ingo Zobel; Berlin. Josef Bailer; Mannheim; Katrin Wambach; Marburg. Matthias Backenstrass; Heidelberg, Stuttgart. Dieter Schoepf; Bonn, Weilmnünster. Knut Schnell; Göttingen. Antje Gumz, Bernd Löwe; Hamburg-Eppendorf. Henrik Walter; Berlin. Markus Wolf; Zürich.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities

Research Areas and Centers

Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)

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Cite this

@article{542ba6b30b2641289949934a78e637a5,

title = "Effects of alliance ruptures and repairs on outcomes",

abstract = "Objective: This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Method: Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP: 134; SP: 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients{\textquoteright} and therapists{\textquoteright} rating separately. Based on the reliable change in the HAQ from one session to the next categories were: no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome. Results: The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome: in the unrepaired rupture category, patients had higher HRSD-ratings across time points (p = 0.047). Conclusions: CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes. Trial registration:ClinicalTrials.gov identifier: NCT00970437.",

author = "Elke Humer and Elisabeth Schramm and Klein, \{Jan Philipp\} and Martin H{\"a}rter and Martin Hautzinger and Christoph Pieh and Thomas Probst",

note = "Funding Information: This study was funded by grants from the German Research Foundation (SCHR443/11-2, SCHN1204/3-1, and WA1539/4-1). The sponsor (German Research Foundation) has reviewed and approved the study protocol in the context of the grant application process. It had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The full study team consists of Levente Kriston, Ramona Meister; Hamburg-Eppendorf. Moritz Elsaesser, Thomas Fangmeier, Paul Bausch, Katharina Domschke, Mathias Berger; Freiburg. Ingo Zobel; Berlin. Josef Bailer; Mannheim; Katrin Wambach; Marburg. Matthias Backenstrass; Heidelberg, Stuttgart. Dieter Schoepf; Bonn, Weilmn{\"u}nster. Knut Schnell; G{\"o}ttingen. Antje Gumz, Bernd L{\"o}we; Hamburg-Eppendorf. Henrik Walter; Berlin. Markus Wolf; Z{\"u}rich. Publisher Copyright: {\textcopyright} 2021 Society for Psychotherapy Research. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

doi = "10.1080/10503307.2021.1874070",

language = "English",

volume = "31",

pages = "977--987",

journal = "Psychotherapy Research",

issn = "1050-3307",

publisher = "Routledge",

number = "8",

}

TY - JOUR

T1 - Effects of alliance ruptures and repairs on outcomes

AU - Humer, Elke

AU - Schramm, Elisabeth

AU - Klein, Jan Philipp

AU - Härter, Martin

AU - Hautzinger, Martin

AU - Pieh, Christoph

AU - Probst, Thomas

N1 - Funding Information: This study was funded by grants from the German Research Foundation (SCHR443/11-2, SCHN1204/3-1, and WA1539/4-1). The sponsor (German Research Foundation) has reviewed and approved the study protocol in the context of the grant application process. It had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The full study team consists of Levente Kriston, Ramona Meister; Hamburg-Eppendorf. Moritz Elsaesser, Thomas Fangmeier, Paul Bausch, Katharina Domschke, Mathias Berger; Freiburg. Ingo Zobel; Berlin. Josef Bailer; Mannheim; Katrin Wambach; Marburg. Matthias Backenstrass; Heidelberg, Stuttgart. Dieter Schoepf; Bonn, Weilmnünster. Knut Schnell; Göttingen. Antje Gumz, Bernd Löwe; Hamburg-Eppendorf. Henrik Walter; Berlin. Markus Wolf; Zürich. Publisher Copyright: © 2021 Society for Psychotherapy Research. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021

Y1 - 2021

N2 - Objective: This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Method: Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP: 134; SP: 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients’ and therapists’ rating separately. Based on the reliable change in the HAQ from one session to the next categories were: no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome. Results: The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome: in the unrepaired rupture category, patients had higher HRSD-ratings across time points (p = 0.047). Conclusions: CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes. Trial registration:ClinicalTrials.gov identifier: NCT00970437.

AB - Objective: This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Method: Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP: 134; SP: 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients’ and therapists’ rating separately. Based on the reliable change in the HAQ from one session to the next categories were: no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome. Results: The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome: in the unrepaired rupture category, patients had higher HRSD-ratings across time points (p = 0.047). Conclusions: CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes. Trial registration:ClinicalTrials.gov identifier: NCT00970437.

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U2 - 10.1080/10503307.2021.1874070

DO - 10.1080/10503307.2021.1874070

M3 - Journal articles

AN - SCOPUS:85100176968

SN - 1050-3307

VL - 31

SP - 977

EP - 987

JO - Psychotherapy Research

JF - Psychotherapy Research

IS - 8

ER -

Effects of alliance ruptures and repairs on outcomes

Abstract

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UN SDGs

Research Areas and Centers

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