| 1. |
- Hoffart, Asle, 1952-, et al.
(författare)
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Do general therapy change principles represent causal relationships?
- 2014
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Ingår i: Journal of psychotherapy integration. - : American Psychological Association (APA). - 1053-0479 .- 1573-3696. ; 24:4, s. 280-283
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In his reply to our critique of the idea to integrate psychotherapies on the basis of general therapy change principles (TCPs), Goldfried (2014) maintains that these principles represent causal connections. In this comment, we argue that attributing a causal status to the TCPs involves seeing them as latent constructs, which is associated with a number of conceptual problems. A causal network analysis of observable symptoms, targets of change, and procedures, explained within a causal schema, appears to be a viable alternative. We further argue that the TCPs seem to represent something we know about humans by being human. Denial of these principles makes no sense. Thus, they lack the hallmark of empirical propositions that their denial is logically possible. Consequently, the TCPs cannot be refuted by experience.
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| 2. |
- Hoffart, Asle, 1952-, et al.
(författare)
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Psychotherapy integration through general therapy change principles : Missing the core of psychotherapy?
- 2014
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Ingår i: Journal of psychotherapy integration. - : American Psychological Association (APA). - 1053-0479 .- 1573-3696. ; 24:4, s. 263-274
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Tidskriftsartikel (refereegranskat)abstract
- It has been proposed to integrate psychotherapies on the basis of general therapy change principles (TCPs). In this theoretical study, the authors analyzed the concept of psychotherapy and evaluated the TCPs' integrative approach from the position of this concept. The authors found that the TCPs' conceptualization is largely inconsistent with the concept of psychotherapy and contains assumptions that either raise conceptual issues or do not appear to fit with clinical evidence. In contrast to what is asserted or implied in the TCPs' approach, the abstract nature of the change principles means that they do not denote causal relationships, are not empirically testable, and cannot serve as a useful guide for clinical action. Moreover, the embeddedness of therapy procedures in causal schemas makes the assumption that therapists can master a multitude of procedures from different therapies unrealistic. Also against the assumptions of the TCPs' approach, the total effect of therapy is probably not the sum of the effects of the procedures and procedures and rationales from different therapies cannot be combined. Overall, the issues of the TCPs' integrative approach seem to stem from the omission of the essential feature of psychotherapy: to operate according to causal schemas of psychological phenomena. The authors argue that a focus on differences between therapies instead of common principles may lead to important assimilative integrations.
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| 3. |
- Fluckiger, Christoph, et al.
(författare)
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The Reciprocal Relationship Between Alliance and Early Treatment Symptoms: A Two-Stage Individual Participant Data Meta-Analysis
- 2020
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Ingår i: Journal of Consulting and Clinical Psychology. - : AMER PSYCHOLOGICAL ASSOC. - 0022-006X .- 1939-2117. ; 88:9, s. 829-843
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Even though the early alliance has been shown to robustly predict posttreatment outcomes, the question whether alliance leads to symptom reduction or symptom reduction leads to a better alliance remains unresolved. To better understand the relation between alliance and symptoms early in therapy, we meta-analyzed the lagged session-by-session within-patient effects of alliance and symptoms from Sessions I to 7. Method: We applied a 2-stage individual participant data meta-analytic approach. Based on the data sets of 17 primary studies from 9 countries that comprised 5,350 participants, we first calculated standardized session-by-session within-patient coefficients. Second, we meta-analyzed these coefficients by using random-effects models to calculate omnibus effects across the studies. Results: In line with previous meta-analyses, we found that early alliance predicted posttreatment outcome. We identified significant reciprocal within-patient effects between alliance and symptoms within the first 7 sessions. Cross-level interactions indicated that higher alliances and lower symptoms positively impacted the relation between alliance and symptoms in the subsequent session. Conclusion: The findings provide empirical evidence that in the early phase of therapy. symptoms and alliance were reciprocally related to one other, often resulting in a positive upward spiral of higher alliance/lower symptoms that predicted higher alliances/lower symptoms in the subsequent sessions. Two-stage individual participant data meta-analyses have the potential to move the field forward by generating and interlinking well-replicable process-based knowledge.
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| 4. |
- Mörtberg, Ewa, et al.
(författare)
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Shifting the Focus of One's Attention Mediates Improvement in Cognitive Therapy for Social Anxiety Disorder
- 2015
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Ingår i: Behavioural and Cognitive Psychotherapy. - 1352-4658 .- 1469-1833. ; 43:1, s. 63-73
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cognitive therapy is an effective treatment for social anxiety disorder but little is known about the mechanisms by which the treatment achieves its effects. Aims: This study investigated the potential role of self-focused attention and social phobia related negative automatic thoughts as mediators of clinical improvement. Method: Twenty-nine patients with social phobia received individual cognitive therapy (ICT) in a randomized controlled trial. Weekly process and outcome measures were analysed using multilevel mediation models. Results: Change from self-focused to externally focused attention mediated improvements in social anxiety one week later. In contrast, change in frequency of, or belief in, negative social phobia related negative automatic thoughts did not predict social anxiety one week later. Conclusions: Change in self-focused attention mediate therapeutic improvement in ICT. Therapists should therefore target self-focused attention.
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| 5. |
- Wergeland, Gro Janne H., et al.
(författare)
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Predictors of school-based cognitive behavior therapy outcome for youth with anxiety
- 2023
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 169
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Tidskriftsartikel (refereegranskat)abstract
- Meta-analyses of school-based CBT have shown that prevention for anxiety symptoms typically report small but significant effects. There is limited knowledge regarding which youths may benefit most and least from such programs, and characteristics of youth who respond differentially to interventions of different intensity. The present study examined predictors of school-based CBT outcomes among 302 youths (mean age 14.0 years, SD 0.8, 84% female) who participated in a randomized waitlist-controlled trial comparing a 10-session and a 5-session group intervention. Potential predictors included youth and parental factors, and credibility and expectancy of the interventions. Pre-intervention anxiety and depression levels, and clinician rated severity were examined as moderators of intervention effects. Outcomes were youth-, and parent-reported youth anxiety and depressive symptoms at post-intervention and 1-year follow-up. Higher parent-reported impairment from youth anxiety predicted larger parent-reported anxiety and depressive symptom change, whereas higher caregiver strain was associated with less symptom change. Higher parent rated credibility and expectancy was associated with improved outcomes at post-intervention. At 1-year follow-up, no predictors of outcome were identified. No moderators were identified. Families with high levels of caregiver strain associated with youth anxiety may need extra support regardless of length of intervention program. Parents’ credibility and expectancy of interventions should be targeted to optimize school-based CBT.
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