Therapeutic Alliance Tensions and Repair in Psychotherapy Practices: A Psychotherapy Practice Research Network (PPRNet) Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 84
- 试验地点
- 4
- 主要终点
- Mean tension resolution rating scale
研究概览
简要总结
This study evaluates a professional development program intended to improve the relationship or alliance between therapists and patients/clients who are receiving psychotherapy in the community. Half of the participating therapists will receive training to detect and improve alliance with new patients while half will not. The professional development training is expected to improve therapists effectiveness in identifying and correcting alliance tensions which will, in turn, improve therapeutic outcomes for patients/clients.
详细描述
Psychotherapy is the treatment of choice for many mental disorders, yet there is a gap between research and practice. Research indicates that: the therapist-patient alliance is important to reduce patient symptoms, alliance tensions are detrimental to patients, and those therapists who identify and repair alliance tensions can improve patient outcomes. In this study we will use state of the art research to train community-based therapists in evidence-based interventions to identify and repair alliance tensions. Trained therapists and their patients will be compared to therapists who provide usual care to their patients. Improvement in therapists' skills in identifying and repairing alliance tensions and how this is associated with better patient mental health outcomes will be measured. Trained therapists will be interviewed to identify the best ways of improving the training and disseminating the findings to psychotherapists across Canada. Research to improve practicing therapists' ability to identify and repair therapeutic alliance tensions will result in better mental health outcomes for patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
Participating therapists will be aware of their group (Asynchronous virtual training, synchronous virtual workshop training, no training control); however, their participating patient/clients will not know which experimental group their therapists belongs to.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Inclusion Criteria:
- •regulated health professional
- •in good standing with a Canadian provincial regulatory college
- •scope of practice includes psychotherapy
- •ability to add 3 or more new, English speaking clients to caseload over 6 to 9 months
- •ability to obtain timely permission to conduct research from therapist's employing institution or health group when applicable
排除标准
- •Patient/Client
- •Inclusion Criteria:
- •18 years of age or older
- •will participate in psychotherapy sessions in English
- •will see the study-affiliated therapist for a minimum of 6 sessions in the next 6 months
- •Exclusion Criteria:
- •already seeing another therapist
- •diagnosed with a neurocognitive disorder
- •diagnosed with a psychotic disorder
- •expressed suicidal behaviour in the past six months as assessed by their participating therapist
研究组 & 干预措施
Professional Development Program
Therapists who participate in workshops and consultation sessions with study trainers during study-related therapy sessions and their participating patients/clients.
干预措施: Professional development program (Other)
Control
Therapists who did not participate in workshops and consultations sessions while engaging in study-related therapy sessions and their participating patients/clients.
结局指标
主要结局
Mean tension resolution rating scale
时间窗: 6 therapy sessions over 6 weeks up to 6 months depending on the frequency of therapy
The Rupture Resolution Rating System (3RS) is an observer-based measure to identify alliance tensions and resolution processes. Independent blind reliable trained judges will rate video recordings of 6 psychotherapy session recorded with participating clients. A mean tension score will be assigned per client which will be the average of the 6 session scores. score ranges from 1 (withdrawal/confrontation rupture(s) did not occur; not significant for the alliance) to 5 (withdrawal/confrontation rupture(s) occurred; significant for the alliance).
次要结局
- Generalized Anxiety Disorder 7-item scale (GAD-7) change from baseline(baseline and end of 6 therapy sessions, 6 weeks to 6 months depending on the frequency of therapy)
- Patient Health Questionnaire 9-item scale (PHQ-9) change from baseline(baseline and end of 6 therapy sessions, 6 weeks to 6 months depending on the frequency of therapy)
研究者
Giorgio A. Tasca
Associate Professor
University of Ottawa