| 1. |
- Sandell, Rolf, et al.
(författare)
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Credibility clusters, preferences, and helpfulness beliefs for specific forms of psychotherapy
- 2011
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Ingår i: Psychology and Psychotherapy. - : British Psychological Society. - 1476-0835 .- 2044-8341. ; 84:4, s. 425-441
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Tidskriftsartikel (refereegranskat)abstract
- Background. There is some evidence that the perceived credibility of specific forms of psychotherapy, beliefs about helpful and not-so-helpful interventions, and differential treatment preferences may influence both therapeutic alliance and outcome, at least in the short term. The present study explored whether distinct clusters exist, based on credibility ratings, and how these may be related to treatment preferences and beliefs about the helpfulness of specific interventions. less thanbrgreater than less thanbrgreater thanMethod. Written descriptions of psychodynamic, cognitive, and cognitive-behavioural psychotherapy were rated by a random community sample with the normal level of psychiatric treatment (n = 121), psychiatric outpatients with limited previous experience of psychiatric care (n = 118), and a group of psychiatric veterans with long experience of psychiatric care (n = 48). Participants completed a questionnaire focusing on beliefs about the helpfulness of specific therapy components, rated the credibility of each form of psychotherapy, and ranked the alternatives in terms of preferences. less thanbrgreater than less thanbrgreater thanResults. Using cluster analysis, six distinct groups of participants were delineated. Some approached psychotherapy in an undifferentiated manner, tending to either embrace all or reject all of the methods examined. Others had differentiated ideas about the credibility of specific therapeutic approaches. These clusters were strongly associated with differential treatment preferences. They were also associated with helpfulness beliefs, type of psychological problems, previous experiences with psychotherapy, and gender. Analysis of the interactions among these factors revealed that the distribution across clusters was almost entirely accounted for by the helpfulness beliefs. less thanbrgreater than less thanbrgreater thanConclusions. For clinicians, it may be important to investigate the differential appeal of specific components of psychotherapy as well as entire therapy packages in individual cases prior to commencing therapy. For researchers, it may be important to consider whether outcome studies would become more informative by taking patients beliefs and preferences into account.
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| 2. |
- Frankl, My, et al.
(författare)
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Psychotherapy role expectations and experiences Discrepancy and therapeutic alliance among patients with substance use disorders
- 2014
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 87:4, s. 411-424
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe main aim of the study was to examine how the discrepancy between role expectations prior to psychotherapy and experiences of ongoing psychotherapy related to therapeutic alliance. We hypothesized that a similarity between patient role expectations and experiences would be associated with a stronger alliance. The study also examined whether different dimensions of psychotherapy role expectations predicted retention in psychotherapy. DesignA naturalistic study design was used with data collected prior to therapy and during the first 6months of therapy. MethodPatients with substance use disorders completed the Psychotherapy Expectation Questionnaire-short version (PEX-S) at the time of therapy assessment. A subsample of these patients (n=41; n=24 in individual therapy and n=17 in group therapy) provided data from therapy including psychotherapy experiences (also measured with PEX-S) and therapeutic alliance, measured with Working Alliance Questionnaire-short version. ResultsFor patients in group therapy, discrepancy between role expectations and experiences correlated negatively with alliance. Expectations prior to psychotherapy characterized by defensiveness correlated negatively with therapy retention. ConclusionThe finding that disconfirmation of patients' role expectations in group therapy were associated with weaker therapeutic alliance highlights the importance of discussing psychotherapy expectations at an early stage in treatment. Expectations characterized by defensiveness predicted worse retention in psychotherapy, which indicates that the PEX-S can be helpful in detecting patients at risk for dropout. Practitioner points In targeting a patient's role expectancies prior to treatment, possible discrepancies between patient and therapist are made visible and possible to examine. Clarifying the patient's role expectations and the therapist's rationale might be a first step towards establishing a strong working alliance. Surveying the patient's defensiveness tendencies at the beginning of therapy offers a chance to discuss possible fears and other obstacles concerning therapy. Discrepancy between the patient's role expectations prior to treatment and their actual experiences of psychotherapy render valuable information that can be of use in the therapy process. 10.1111/(ISSN)2044-8341
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| 3. |
- Andersson, Gerhard, 1966-, et al.
(författare)
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Memories of significant episodes in child psychotherapy : An autobiographical memory approach
- 2006
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Ingår i: Psychology and Psychotherapy. - 1476-0835 .- 2044-8341. ; 79:2, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- In this study, child psychotherapists (N = 31) were asked to retrieve emotionally valenced therapy episodes by using an autobiographical memory approach, with cue words to elicit specific therapy episodes (e.g. irritated, ashamed, loving, and elated). One group of teachers for the disabled (N = 10) and one group of music therapists (N = 9) were also tested and served as comparison groups. Results showed that all participants were able to retrieve memories of episodes. When asked to rate each memory, negative memories were returned to less often, and overall positive memories were rated as more easy to recall and more vivid. Memories derived from positive cue words were also judged to have a more positive compared with negative importance for outcome. Surprisingly, memories derived from the cue word irritated were seen as having more positive than negative importance for outcome. Finally, we checked memory specificity for each memory derived. A high degree of specificity was found overall (72-88%). In conclusion, cue words might be a useful way to generate specific memories of therapy episodes in future research. © 2006 The British Psychological Society.
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| 4. |
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| 5. |
- Björck, Caroline, et al.
(författare)
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Self-image and treatment drop-out in eating disorders
- 2008
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Ingår i: Psychology and Psychotherapy. - Leicester, UK : British Psychological Society. - 1476-0835 .- 2044-8341. ; 81:1, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Drop-out from treatment is a serious problem in eating disorders which remains poorly understood. The present study investigated whether self-image and interpersonal theory could help to explain why eating disorder patients drop out of treatment. Method: Intake data on eating disorder patients who terminated treatment prematurely (N=54) were compared with patients who had completed treatment (N=54) and those who were still in treatment after 12 months (N=54). Self-image was assessed using the structural analysis of social behaviour (SASB), and comparisons were made on demographic and clinical variables. Results: Patients who dropped out had initially presented with less negative self-image and fewer psychological problems compared with remainers. Low levels of SASB self-blame discriminated drop-outs from completers and remainers and significantly predicted treatment drop-out. Discussion: Drop-out in eating disorders appears to be a complex phenomenon, not necessarily as pathological as often assumed. There may be important differences in the treatment goals of drop-outs and therapists; patients who drop out may be choosing to disengage at a time when symptom improvement creates space for closer examination of interpersonal issues.
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| 6. |
- Bragesjo, M., et al.
(författare)
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The credibility of psychodynamic, cognitive and cognitive-behavioural psychotherapy in a randomly selected sample of the general public
- 2004
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 77:3, s. 297-307
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the credibility of psychodynamic, cognitive and cognitive-behavioural psychotherapy in the general population. Methods: A random sample (N = 121) of individuals from the county of Östergötland in Sweden between 20 and 60 years of age rated written descriptions of the three forms of psychotherapy. Results: A clear majority of respondents rated cognitive and cognitive-behavioural therapies as more credible than psychodynamic therapy, although the latter was rated as the most credible form of psychotherapy among those who had previous experience of treatment for psychological distress. Conclusions: Each form of psychotherapy appears to have its own 'market segment' with a high degree of credibility to those within that segment.
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| 7. |
- Ferreira, Cláudia, et al.
(författare)
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Getting entangled with body image : Development and validation of a new measure
- 2015
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Ingår i: Psychology and Psychotherapy. - : John Wiley & Sons. - 1476-0835 .- 2044-8341. ; 88:3, s. 304-316
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Several studies have highlighted the role of cognitive fusion on human suffering and a wide range of psychopathological conditions. Namely, this process has been regarded as a core aspect in eating disorders. Nevertheless, the study of cognitive fusion on eating psychopathology is scarce and a measure that specifically concerns body image was still to be created. The present study aimed therefore at developing and validating such measure, the Cognitive Fusion Questionnaire - Body Image (CFQ-BI).Design and methods: The current study was conducted using different samples of both genders, collected in the general and student populations. The dimensionality of the CFQ-BI was tested through an exploratory factor analysis and a confirmatory factor analysis (CFA). The scale's internal reliability and other psychometric qualities were also analysed.Results: The CFQ-BI's final structure was one-dimensional and comprised 10 items that assess body image-related cognitive fusion. This final structure explained a total of 73.41% of the variance. The adequacy of the questionnaire was corroborated through a CFA which revealed that CFQ-BI presents good global and local adjustment values and goodness-of-fit indices. Results also showed that the CFQ-BI holds a very good internal consistency (=.96), convergent, divergent and temporal reliabilities, and is able to discriminate cases from non-cases of eating psychopathology.Conclusions: The CFQ-BI was thus established as a short, robust, and reliable measure of body image-related cognitive fusion. This new measure may correspond to a significant contribution to research and clinical practice in the field of body image and eating-related difficulties.
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| 8. |
- Forsén Mantilla, Emma, et al.
(författare)
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Insidious : The relationship patients have with their eating disorders and its impact on symptoms, duration of illness, and self-image
- 2018
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Ingår i: Psychology and Psychotherapy. - : WILEY. - 1476-0835 .- 2044-8341. ; 91:3, s. 302-316
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesIn published clinical and autobiographical accounts of eating disorders, patients often describe their disorder in personified ways, that is, relating to the disorder as if it were an entity, and treatment often involves techniques of externalization. By encouraging patients to think about their eating disorder as a relationship, this study aimed to examine how young female patients experience their eating disorder as acting towards them, how they react in response, and whether these interactions are associated with symptoms, illness duration, and self-image. DesignStructural Analysis of Social Behavior (SASB) was used to operationalize how patients experience the actions of their eating disorder and their own reactions to the disorder. MethodThe relationship between patients (N=150) and their eating disorders was examined with respect to symptoms, duration of illness, and self-image. Patients were also compared on their tendency to react with affiliation in relation to their disorder. ResultsPatients' responses on the SASB indicated that they tended to conceptualize their eating disorders as blaming and controlling, and they themselves as sulking and submitting in response. Greater experience of the eating disorder as being controlling was associated with higher levels of symptomatology. Patients reacting with more negative affiliation towards their disorder were less symptomatic. ConclusionsWhen encouraging patients to think about their eating disorder as a relationship, comprehensible relationship patterns between patients and their eating disorders emerged. The idea that this alleged relationship may resemble a real-life relationship could have theoretical implications, and its exploration may be of interest in treatment. Practitioner points Patients were able to conceptualize their eating disorder as a significant other to whom they relate when encouraged to do so. Patients tended to experience their disorder as controlling and domineering. Exploring the hypothetical patient-eating disorder relationship may prove helpful in understanding dysfunctional relational patterns. Helping patients to rebel against their eating disorder could potentially aid in symptom reduction.
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| 9. |
- Forsén Mantilla, Emma, et al.
(författare)
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The unsafe haven : Eating disorders as attachment relationships
- 2019
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Ingår i: Psychology and Psychotherapy. - : WILEY. - 1476-0835 .- 2044-8341. ; 92:3, s. 379-393
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Some patients with eating disorders (EDs) seem to experience their illness as an entity, a symbolic other to whom they relate, and which may influence both symptom levels and self-image. Extending previous research, this study investigated whether the patient-ED relationship has attachment qualities. Design Structural Analysis of Social Behaviour was used to operationalize the patient-ED relationship, and the Attachment Style Questionnaire was used to measure attachment. Method We examined ED patients' (N = 148) relationship with their ED, attachment behaviour, symptoms, and self-image. Attachment dimensions of Confidence, Anxious/ambivalence, and Avoidance were found to be significantly correlated with aspects of the patient-ED relationship. Introjection (i.e., whether ED actions were incorporated into patients' self-image) was investigated by examining the match between self-image profiles and the actions of patients' EDs. A double mediation model was tested in which ED control/emancipation and patients' Self-blame mediated the effect of attachment security on ED symptoms. Results Attachment insecurity was associated with greater ED control and patient submission. In 28.5% of patients, there was a high degree of correlation between self-image and ED action profile. Data supported the mediation model. Conclusions Attachment processes appear to be associated with the manner in which ED patients relate to their disorder, at least in some cases. Attempts to maintain psychological proximity to the ED as an introjected attachment figure may help to explain treatment resistance and ambivalence about change. This perspective may be useful in treatment. Practitioner points Attachment behaviours are associated with the patient-ED relationship, in which attachment insecurity is correlated with greater eating disorder control and patient submission. Some patients seem to incorporate the actions of the ED in their self-image, suggesting the presence of introjection. The patient-ED relationship may help explain patients' anxiety and ambivalence about change, seen from an attachment perspective. In treatment, it may be important to explore alternative safe havens and secure bases to the ED, such as interpersonal relationships and activities.
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| 10. |
- Frovenholt, J., et al.
(författare)
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How do experiences of psychiatric care affect the perceived credibility of different forms of psychotherapy?
- 2007
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Ingår i: Psychology and Psychotherapy. - 1476-0835 .- 2044-8341. ; 80:2, s. 205-215
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Tidskriftsartikel (refereegranskat)abstract
- Background. The study examined the influence of experience with psychiatric treatment on the perceived credibility of psychodynamic (PDT), cognitive (CT) and cognitive-behavioural psychotherapy (CBT). Methods. Written descriptions of the three forms of psychotherapy were rated by three groups of subjects with different levels of experience of psychiatric treatment, a random community sample with the normal level of psychiatric treatment (N = 121), psychiatric out-patients with limited previous experience of psychiatric care (N = 118), and a group of psychiatric veterans with long experience of psychiatric care (N = 48). Results. Besides a significant main effect of psychotherapy form on credibility, the interaction between psychotherapy form and level of previous experience of psychiatric care was highly significant. When respondents ranked the three forms of psychotherapy, there was an overrepresentation of preferences for CBT (and 'don't know' responses) among the general public, whereas the two patient samples were less indecisive and more often preferred PDT and, in particular, CT. Conclusions. Different forms of psychotherapy appear to have their own market segments, the size of which varies depending on previous experiences of psychological distress and psychiatric treatment. © 2007 The British Psychological Society.
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| 11. |
- Gidhagen, Ylva, 1951-, et al.
(författare)
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Attachment style among outpatients with substance use disorders in psychological treatment
- 2018
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 91:4, s. 490-508
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the associations between self-rated attachment style, psychological distress and substance use among substance use disorder (SUD) outpatients in psychological treatment.Design and Methods In this practice-based study, 108 outpatients were asked to fill in the Experiences in Close Relationships - Short form, the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), the Alcohol Use Disorders Identification Test (AUDIT), and the Drug Use Disorders Identification Test (DUDIT) at treatment start and end. Patients were given psychological treatments with a directive, reflective or supportive orientation.Results An insecure attachment style was more common among the SUD outpatients, compared to non-clinical groups. Patients with a fearful attachment style scored higher on psychological distress than patients with a secure attachment style. The associations between the attachment dimensions and psychological distress were stronger than those between attachment and SUD. Significantly more patients had a secure attachment style at treatment end.Conclusions This study shows significant relations between patients' attachment style and their initial psychological distress. The causal relationship between attachment style and psychological distress is, however, not clear and can likely go in both directions. The psychological treatment of patients with SUD contributed significantly to changes from insecure to secure attachment style.
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| 12. |
- Hewitt, Olivia Mary, et al.
(författare)
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The phenomenology of mental imagery in people with intellectual disabilities
- 2023
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Ingår i: Psychology and Psychotherapy. - : Wiley-Blackwell. - 1476-0835 .- 2044-8341. ; 96:1, s. 25-39
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Mental imagery is important in the development and maintenance of psychological disorders and well-being but has been neglected in people with intellectual disabilities. A detailed idiographic analysis of the lived experience of mental imagery in this population is presented.Design: This qualitative study uses interpretative phenomenological analysis (IPA). It involved inclusive research methods with people with intellectual disabilities and other stakeholders (including family members, advocates, support workers and intellectual disability service managers).Methods: Ten individual semi-structured interviews were conducted with people with mild-moderate intellectual disabilities. Participants were opportunistically sampled through organisations providing community services to people with intellectual disabilities in the UK. Two men and eight women (mean age 43 years) participated. Interviews were audio-recorded and analysed using IPA.Results: People with intellectual disabilities are able to experience a range of rich and detailed mental images across all sensory modalities. Participants reported changes in affect based on mental imagery, and an ability to experience both spontaneous and deliberate mental images. The emotional saliency of the object of mental imagery appeared to influence participants' ability to engage with imagery. A number of adaptations make mental imagery more accessible and easier to report. The ability of people with intellectual disabilities to experience vivid mental imagery has important clinical implications for the use of a range of mental imagery interventions with this population.Conclusions: The need to consider mental imagery interventions for this population, and how these can be adapted to ensure accessibility is a priority for people with intellectual disabilities and psychological disorders.
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| 13. |
- Holmqvist, Rolf, 1948-, et al.
(författare)
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Patients' relationship episodes and therapists' feelings
- 2002
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 75:4, s. 393-409
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Tidskriftsartikel (refereegranskat)abstract
- The idea that psychotherapists' feelings may reflect some aspect of the content in the patients' material has long been clinically accepted but on the whole poorly systematically studied. The aim of this study was to analyse associations between relationship episodes told by patients at evaluation interviews, and therapists' subsequent feelings towards the patients. In total, 28 psychotherapies with nine psychotherapists were studied. Before therapy started, the clients were interviewed separately by the eventual therapist and a second interviewer and six relationship episodes were written down by the interviewers. During the therapy, the therapists reported their feelings on a 'feeling checklist' after each therapy session. In a first analysis, the relationship episodes were categorized according to the CCRT system. The results indicated only scattered associations between CCRT categories and therapist feelings. The results were, however, difficult to interpret as it was found that the therapists' feeling patterns were quite homogenous for each therapist. Considering this, qualitative analyses were made of six therapies carried out by two therapists. These analyses revealed different but theoretically plausible patterns between the feelings attributed to the persons in the patients' relationship episodes and the therapists' subsequent feelings towards the patients. The results were interpreted as a confirmation of the purported relations between patient relationship episodes and therapist feelings, but also as pointing to the need to develop the understanding of these patterns. It seems particularly important to emphasize the importance of the therapist's own habitual feeling patterns when the impact of the patient's internalized relationship patterns on countertransference reactions is evaluated.
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| 14. |
- Holmqvist, Rolf, et al.
(författare)
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Sources of psychiatric staff members' feelings towards patients and treatment outcome
- 2006
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Ingår i: Psychology and Psychotherapy. - Leicester, UK : British Psychological Society. - 1476-0835 .- 2044-8341. ; 79:4, s. 571-584
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Tidskriftsartikel (refereegranskat)abstract
- This study had two purposes. The first was to assess to what extent psychiatric staff members' feelings towards patients in small psychiatric units could be attributed to (a) the individual staff member's habitual feeling style, (b) stable and consistent feelings towards individual patients (the patient's evocative style) and (c) the interaction between these two factors. The second purpose was to analyse the associations between the proportions of these factors and the average outcome for the patients in the units. The study was based on a previously presented model for analysing sources of staff counter-transference. The model specifies contributions from the different sources by using two-way ANOVAs. In the present study, data from 21 psychiatric treatment units for patients with psychosis and personality disorder were used. The results indicated that the staff members' individual habitual feeling style and the interaction between this habitual feeling style and the patient's evocative style contributed most to the variance in staff feelings. Patients' individual evocative patterns contributed less. Positive treatment outcome was mainly negatively associated with contributions to the staff counter-transference from these sources, implying that fixed patterns in personal feeling style or fixed reaction styles to individual patients had a negative influence on outcome. © 2006 The British Psychological Society.
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| 15. |
- Lazar, A., et al.
(författare)
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Subjective health and ill health-related behaviour
- 2007
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Ingår i: Psychology and Psychotherapy. - 1476-0835 .- 2044-8341. ; 80:2, s. 297-309
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of this study was to investigate the relation between self-rated health measures and ill healthrelated behaviour. Design. The study design was based on a self-report questionnaire taken for three consecutive years. Method. Path analysis was used to test the relations between (a) The Self-rated Health Scale (SRH) and the General Symptom Index (GSI) from the Symptom Checklist-90 (SCL-90), and (b) self-reports on sick leave, health care utilization and medication, in a group of 155 persons who had terminated psychotherapeutic treatment the year before our three-year panel survey. To investigate the potential moderating function of ongoing psychotherapeutic treatment, we repeated each test in a group of 152 patients in the midst of psychotherapeutic treatment. Results. Only weak or zero relations were found between the self-rated health measures and ill health-related behaviour. The multi-group analyses indicated between-group differences in model fit. The few significant specific between-group differences all concerned autoregressive relations. Conclusions. Subjective health did not predict ill health-related behaviour. Ongoing psychotherapeutic treatment did not affect the predictive value of subjective health variables. The weak relations found in the current study illuminate paradoxical outcome differences between subjective well-being and ill health-related behaviour. Our findings are discussed in the light of cultural and personality factors. © 2007 The British Psychological Society.
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| 16. |
- Lindgren, Annika, et al.
(författare)
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Long-term outcome and post-treatment effects of psychoanalytic psychotherapy with young adults
- 2010
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Ingår i: Psychology and Psychotherapy. - : Wiley-Blackwell. - 1476-0835 .- 2044-8341. ; 83:Pt 1, s. 27-43
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The short- and long-term effects of open-ended, long-term psychoanalytic psychotherapy for young adults were investigated. Possible changes during the year and a half follow-up, as well as predictors of change, were explored.DESIGN: Patients aged 18-25 years who accepted the offered psychoanalytic individual or group psychotherapy were included. Patients filled out questionnaires and were interviewed at intake, termination, and follow-up. Alliance data were collected after the second session of psychotherapy proper.METHODS: The primary outcome measures were the Symptom Checklist-90 and the Inventory of Interpersonal Problems. The Helping Alliance Questionnaire-II was used to measure alliance. Mixed model ANOVAs were used to analyse changeover time and prediction of change in relation to gender, treatment format, treatment duration, and in individual psychotherapy, therapist- and patient-rated alliance.RESULTS: All outcome measures changed significantly from intake to follow-up. None changed significantly during the follow-up period, but there was a tendency towards recurring symptoms and an improvement in one of the object relational measures during the follow-up. The latter was the only outcome measure that did not change significantly during treatment. Lower therapist-rated alliance was predictive of greater change in psychiatric symptoms for patients with high levels of symptoms at intake.CONCLUSIONS: The long-term effectiveness of psychoanalytic psychotherapy for young adults was supported. Low therapist-rated alliance implies that the therapists have identified problematic interactions, which might have mobilized their effort to solve the problems. Further research on cases reporting no gain or even deterioration is needed.
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| 17. |
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| 18. |
- Mörtberg, Ewa, et al.
(författare)
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Predictors of response to individual and group cognitive behaviour therapy of social phobia
- 2014
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 87:1, s. 32-43
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesIncreased knowledge of factors that predict treatment outcome is important for planning and individualizing of treatment. This study analysed predictors of response to individual cognitive therapy (ICT), and intensive (3-week) group cognitive treatment (IGCT) for social phobia. MethodParticipants (n=54) met diagnostic criteria for social phobia within a randomized controlled trial. Predictors assessed were fear of negative evaluation, anticipatory worry, self-directedness (SD) and cluster C personality disorder. Results were analysed by means of multiple regression analyses with both groups combined, and for each of the treatment groups. ResultsAnticipatory worry, an aspect of a harm-avoidance personality trait, was the strongest negative predictor of outcome in ICT and IGCT both at post-treatment and 1-year follow-up. Whereas low SD, signs of cluster C personality disorder and fear of negative evaluation were negative predictors of post-treatment outcome in ICT, the corresponding pattern of results was not to be found in IGCT. ConclusionsAnticipatory worry appears to be a particularly important trait for explaining variance in the outcome of social phobia. The finding is consistent with the assumed stability of such personality traits over time. Further studies are warranted to replicate the finding.
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| 19. |
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| 20. |
- Philips, Björn
(författare)
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Comparing apples and oranges : how do patient characteristics and treatment goals vary between different forms of psychotherapy?
- 2009
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Ingår i: Psychology and Psychotherapy. - : Wiley-Blackwell. - 1476-0835 .- 2044-8341. ; 82:Pt 3, s. 323-336
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim is to investigate whether different modalities and orientations of psychotherapy diverge with regard to patient characteristics and treatment goals, in a naturalistic setting for patients with substance use disorders.DESIGN: All psychotherapies (N=262) during a year were surveyed at the Centre for Dependency Disorders, Stockholm County Council. Data were collected from the psychotherapists (N=38).METHODS: A therapist questionnaire was used, covering the topics of interest. Data regarding problems and goals were categorized using a qualitative clustering method. Differences between therapy formats were analysed using statistical methods.RESULTS: The prevalence of psychological problems among the patients was high (88%). Patients in cognitive behaviour therapy (CBT) and family therapy (FT) had less severe psychological problems than patients in the other psychotherapy formats. With regard to treatment goals, FT focused on improved family relations, group therapies on relational improvements, psychodynamic therapies on insight and improved functioning, while CBT focused on behaviour change and improved motivation for change.CONCLUSIONS: These findings suggest a shortcoming of the aim of the EST movement to consider reduction of target symptom as the only relevant treatment goal and to compare the efficacy of different treatments in this regard.
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| 21. |
- Philips, Björn, et al.
(författare)
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Ideas of cure as a predictor of premature termination, early alliance and outcome in psychoanalytic psychotherapy.
- 2007
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Ingår i: Psychology and Psychotherapy. - : Wiley-Blackwell. - 1476-0835 .- 2044-8341. ; 80:Pt 2, s. 229-245
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study examines how young adult patients' ideas of cure prior to psychoanalytic psychotherapy are associated with premature termination, early alliance and therapy outcome. The hypotheses were that ideas about approaching one's problems would be related to fewer premature terminations, higher early alliance and better outcome, than would ideas about distancing oneself from one's problems.DESIGN: Young adult patients (N=46) were interviewed prior to therapy regarding their ideas of cure. Outcome measures were administered pre- and post-therapy. Alliance measures were administered early in treatment.METHODS: A typology of the patients based on their ideas of cure was performed using ideal type analysis. Clusters of patients were then rank ordered in accordance to the theoretical dimension 'approaching-distancing'. The relation between rank ordered ideas of cure and premature termination was analysed using Mann-Whitney's U-test. These ideas' associations with early alliance and therapy outcome were analysed using Spearman's rho.RESULTS: Patients who terminated therapy prematurely were significantly closer to the 'distancing' pole regarding ideas of cure, while the therapy completers were more often found near the 'approaching' pole. No associations were found between ideas of cure and early alliance or therapy outcome. In addition, patients with attrition due to failure to participate in interviews and complete interviews were significantly closer to the 'distancing' pole than those who had completed their research commitments.CONCLUSIONS: The positive finding regarding premature termination indicates the importance of negotiating ideas of cure as a part of the initial assessment process. Possible explanations for the negative findings are discussed.
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| 22. |
- Philips, Björn, et al.
(författare)
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Young adults in psychoanalytic psychotherapy : patient characteristics and therapy outcome
- 2006
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Ingår i: Psychology and Psychotherapy. - : Wiley-Blackwell. - 1476-0835 .- 2044-8341. ; 79:Pt 1, s. 89-106
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this naturalistic study are to present patient characteristics and analyse various outcome measures at termination for psychoanalytic psychotherapies with young adults. Patients (n = 134) between 18 and 25 years were included, of whom 92 received individual and 42 group therapy. One third had a self-reported personality disorder. The patients were considerably more troubled than Swedish norm groups at intake and they showed improvement on all outcome measures during therapy. However, the post therapy means did not fully reach the norm group means. The largest positive changes (pre- versus post-therapy) were with respect to the patients' overall health and functioning. Changes were more moderate in self-reported symptoms, self-concept, and self-representation, while changes in interpersonal problems and object representations were small. The results of this study are discussed in the context of advantages and disadvantages of naturalistic versus randomized controlled study designs.
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| 23. |
- Rautalinko, Erik, 1969-
(författare)
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Directiveness in psychotherapy : A phenomenological-narrative study of therapist attitudes
- 2017
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835 .- 2044-8341. ; 90:4, s. 600-616
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis study of directiveness draws on the literature on patient–therapist matching, neutrality, and resistance. Our aim was to investigate how psychotherapists conceptualize directiveness as an attitude, with a focus on pantheoretical aspects of directiveness.Design and methodsOur data are narratives from 18 interviews with psychotherapists of different theoretical orientations (cognitive-behavioural, family-systems, humanistic-experiential, and psychodynamic), and from focus-group discussions with six other psychotherapists.ResultsThe analysis yielded four general themes: expression of directiveness (behaviour, agency, structure), its presence (depending on phase of and goals for therapy), its positive and negative outcomes (for patients and therapists, respectively), and therapist awareness (initial and shifting, depending on theoretical orientation).ConclusionsDirectiveness may be construed as an attitude. It supposedly increases via certain responses, but only a few of these are considered positive by therapists at large. Directiveness may be more present in early and late phases of therapy, and more warranted with patients that function poorly. There are both positive and negative outcomes of directiveness, but therapists are more prone to disclose the former.Practitioner pointsTherapist directiveness supposedly increases via advice, questions, clarifications, steering to topics, goal setting, self-disclosure, and session management. Directiveness is seen as more present in early and late phases of therapy.Directing is more warranted with patients who function poorly. Possible positive outcomes of directiveness are clarity, feeling of security, and saving time; negative outcomes are decrease of agency, increase of resistance, and less patient self-attribution of improvement.It is unlikely that therapists disclose adverse directive behaviours. Those who do, attribute them to psychotherapy structure if their attitudes are negative, and to personal choice if they are positive. This may hamper therapists managing their own level of directiveness.
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| 24. |
- Sandell, Rolf, et al.
(författare)
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Therapist attitudes and patient outcomes. III. A latent class analysis of therapists
- 2006
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Ingår i: Psychology and Psychotherapy. - 1476-0835 .- 2044-8341. ; 79:4, s. 629-647
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Tidskriftsartikel (refereegranskat)abstract
- Background. Previous research has reported large differences in treatment results between individual therapists practising the same type of psychotherapy, but little is as yet known about the factors explaining this variation. In previous studies the authors have found associations with therapeutic attitudes as measured by the TASC 2 scales. Methods. A sample of 160 therapists were clustered in a non-parametric latent class (LC) regression modelling of their patients' repeated self-ratings on the SCL-90 across stages in psychotherapeutic treatment. This classification was then explored in relation to the therapists' TASC 2 scores. Results. Five classes were identified differing widely in terms of the patients' outcome trajectories. Membership in these classes was significantly influenced by the therapists' scores on the TASC 2 scales. The adjustment, neutrality and artistry scales of the TASC 2 were found specifically discriminative. A discriminant analysis confirmed the findings in general. Collectively, the TASC 2 scales were able to assign 56% of the therapists to their correct latent class, in comparison with 20% by chance. Conclusions. Therapists with a psychoanalytic or eclectic orientation are systematically different in terms of the outcomes they tend to contribute to with their patients. This variation is partly accounted for by differences in their therapeutic attitudes. © 2006 The British Psychological Society.
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| 25. |
- Wennberg, Peter, et al.
(författare)
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The Swedish version of the Outcome Questionnaire (OQ-45) : Reliability and factor structure in a substance abuse sample
- 2010
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Ingår i: Psychology and Psychotherapy. - : Wiley-Blackwell. - 1476-0835 .- 2044-8341. ; 83:3, s. 325-329
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Tidskriftsartikel (refereegranskat)abstract
- This study described the psychometric properties of the Swedish version of the Outcome Questionnaire (OQ-45.2) in a substance abuse sample (N = 227). The test properties were satisfactory except for somewhat low internal consistency in the social role subscale. The results were similar to those obtained in other countries but systematic international comparisons are still lacking.
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| 26. |
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| 28. |
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| 29. |
- Johansson, Håkan, et al.
(författare)
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Helping alliance and ward atmosphere in psychiatric in-patient care.
- 2004
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Ingår i: Psychology and Psychotherapy. - : Wiley. - 1476-0835. ; 77:Pt 4, s. 511-523
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study investigated how patients in a psychiatric in-patient ward perceived the therapeutic relationship and the ward atmosphere, the interrelationships between these phenomena, and whether demographic and clinical factors had an influence on the helping alliance. DESIGN: This was an explorative study in a natural setting. A correlational and multiple regression design were adopted. METHOD: All discharged patients (N = 61) during a limited period completed questionnaires regarding the ward atmosphere and the helping alliance, were rated on psychosocial functioning, and diagnosed according to the ICD-10. RESULTS: Several ward-atmosphere factors correlated with the helping alliance. A multivariate analysis suggested that support, programme clarity, and spontaneity were important ingredients and that support was the most important contributor. Patients with a high level of psychosocial functioning established a better helping alliance and patients with personality disorders tended to develop a weaker helping alliance. CONCLUSION: The findings emphasize that a holding environment is important in establishing a good helping alliance, which is consistent with results from the psychotherapy area. Since helping alliance is known to have a most important influence on therapy outcome, one conclusion must be that the staff, in their endeavour to strengthen the supportive element of the ward atmosphere, may improve the therapeutic outcome as well.
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| 30. |
- Johansson, Håkan, et al.
(författare)
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Therapeutic alliance and outcome in routine psychiatric out-patient treatment: Patient factors and outcome
- 2010
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Ingår i: Psychology and Psychotherapy. - 1476-0835. ; 83:2, s. 193-206
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Tidskriftsartikel (refereegranskat)abstract
- Objective. This study investigated the importance of the therapeutic alliance in a routine psychiatric out-patient unit regarding treatment outcome and the influence of patient factors. Design. The study had a naturalistic and longitudinal design where the treatments the patient received were determined by the normal routines at the unit and were performed by a variety of staff representative of a psychiatric out-patient unit. Method. Newly admitted patients were diagnosed according to the International Classification of Diseases - 10th Revision and completed questionnaires regarding the therapeutic alliance, symptoms, and interpersonal problems at the beginning and termination of their treatment (N = 76). The time limit for the termination assessments was set at 18 months. Results. The therapeutic alliance at the beginning of treatment did not correlate with outcome, however, at the end of the treatment the alliance significantly explained about 15% of the variance of the outcome (global severity index). An improvement of the alliance during the treatment significantly correlated with most of the outcome variables. The relation of the alliance to outcome was equal among the different diagnosis groups and treatment forms. Conclusion. The results showed that the therapeutic alliance is an important variable for treatment outcome in routine psychiatric treatment, and improving the therapeutic alliance may be one of the most important factors for increasing the total effectiveness of a treatment unit.
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| 31. |
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