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Does the working alliance mediate the effect of routine outcome monitoring (ROM) and alliance feedback on psychotherapy outcomes? A secondary analysis from a randomized clinical trial.

https://arctichealth.org/en/permalink/ahliterature299441
Source
J Couns Psychol. 2019 Mar; 66(2):234-246
Publication Type
Journal Article
Randomized Controlled Trial
Date
Mar-2019
Author
Heidi Brattland
John Morten Koksvik
Olav Burkeland
Christian A Klöckner
Mariela Loreto Lara-Cabrera
Scott D Miller
Bruce Wampold
Truls Ryum
Valentina Cabral Iversen
Author Affiliation
Department of Mental Health.
Source
J Couns Psychol. 2019 Mar; 66(2):234-246
Date
Mar-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Adult
Feedback, Psychological
Female
Health Personnel - standards - trends
Humans
Male
Norway - epidemiology
Professional-Patient Relations
Psychotherapy - standards - trends
Treatment Outcome
Abstract
Little is known about the mechanisms through which routine outcome monitoring (ROM) influences psychotherapy outcomes. In this secondary analysis of data from a randomized clinical trial (Brattland et al., 2018), we investigated whether the working alliance mediated the effect of the Partners for Change Outcome Monitoring System (PCOMS), a ROM system that provides session-by-session feedback on clients' well-being and the alliance. Adult individuals (N = 170) referred for hospital-based outpatient mental health treatment were randomized to individual psychotherapy either with the PCOMS ROM system, or without (treatment as usual [TAU]). Treatment was provided by the same therapists (N = 20) in both conditions. A multilevel mediation model was developed to test if there was a significant indirect effect of ROM on client impairment at posttreatment through the alliance at 2 months' treatment controlled for first-session alliance. Alliance ratings increased more from session 1 to 2 months' treatment in the ROM than TAU condition, and alliance increase was associated with less posttreatment impairment. A significant indirect effect of ROM on treatment outcomes through alliance increase (p = .043) explained an estimated 23.0% of the effect of ROM on outcomes. The results were consistent with a theory of the alliance as one mechanism through which ROM works. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
PubMed ID
30702322 View in PubMed
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Practical ways psychotherapy can support physical healthcare experiences for male survivors of childhood sexual abuse.

https://arctichealth.org/en/permalink/ahliterature137668
Source
J Child Sex Abus. 2011 Jan;20(1):37-57
Publication Type
Article
Date
Jan-2011
Author
Angela Hovey
Carol A Stalker
Candice L Schachter
Eli Teram
Gerri Lasiuk
Author Affiliation
Wilfrid Laurier University, Waterloo, Ontario, Canada. ahovey@pacehealth.com
Source
J Child Sex Abus. 2011 Jan;20(1):37-57
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Adult
Adult Survivors of Child Abuse - psychology
Canada
Child
Child Abuse, Sexual - psychology - rehabilitation
Disclosure
Health promotion
Humans
Male
Patient Acceptance of Health Care
Patient-Centered Care
Professional-Patient Relations
Psychotherapy
Social Support
Abstract
Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse (Schachter, Stalker, Teram, Lasiuk, & Danilkewich, 2009), which is intended to help healthcare providers from all disciplines understand the effect of child sexual abuse on some survivors' abilities to access and benefit from health care. This paper discusses what psychotherapists can learn from the healthcare experiences of the male survivors who participated in this project. It also offers practical suggestions for supporting male clients who experience difficulty seeking treatment for physical health concerns.
PubMed ID
21259146 View in PubMed
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