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Therapist Alliance-...
Therapist Alliance-Building Behaviors, Alliance, and Outcomes in Cognitive Behavioral Treatment for Youth Anxiety Disorders
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Fjermestad, Krister W. (author)
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Føreland, Øyvind (author)
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Oppedal, Silje B. (author)
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Sørensen, Julie S. (author)
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Vognild, Ylva H. (author)
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Gjestad, Rolf (author)
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- Öst, Lars-Göran (author)
- Stockholms universitet,Klinisk psykologi
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Bjaastad, Jon F. (author)
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Shirk, Stephen S. (author)
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Wergeland, Gro Janne (author)
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(creator_code:org_t)
- 2020-01-07
- 2021
- English.
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In: Journal of clinical child and adolescent psychology (Print). - : Informa UK Limited. - 1537-4416 .- 1537-4424. ; 50:2, s. 229-242
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objective: The alliance influences outcomes in CBT for youth anxiety disorders. Thus, knowledge about how therapists can enhance the alliance is needed.Method: Seventy-three youth with anxiety diagnoses (M age = 11.5 years, SD = 2.2; range 8 to 15 years; 47.9% boys; 90.4% white-European) participated in 10-session cognitive behavioral therapy in community clinics. Therapist alliance-building behaviors in session 2 was reliably coded with the observer-rated Adolescent Alliance-Building Behavior Scale (Revised) (AABS(R)). Alliance was measured as youth- and therapist-rated alliance, and youth-therapist alliance discrepancy in session 3. Outcomes were diagnostic recovery and anxiety symptom reduction at post-treatment and one-year follow-up, and treatment dropout. We examined the direct effects of alliance-building on alliance, alliance on outcomes, and alliance-building on outcomes in multilevel mediation models, and between- versus within-therapist variance across these effects.Results: The alliance-building behaviors collaborate, present treatment model, and explore motivation positively predicted alliance, whereas actively structuring the session (i.e., dominating) negatively predicted alliance. The alliance-building behaviors attend to experience, collaborate, explore motivation, praise, and support positively predicted outcomes. The alliance-building behaviors present treatment model, express positive expectations, explore cognitions, and support negatively predicted outcomes. The effect of collaborate on symptom reduction was mediated by youth-therapist alliance discrepancy. There was almost zero between-therapist variance in alliance-building, and considerable within-therapist variance.Conclusion: Therapist alliance-building behaviors were directly (positively and negatively) associated with alliance and/or outcomes, with only one effect mediated by alliance. Alliance-building behaviors varied far more within therapists (i.e., across clients) than between therapists.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
Keyword
- allience
- CBT
- youth
- anxiety disorders
- Psychology
- psykologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Fjermestad, Kris ...
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Føreland, Øyvind
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Oppedal, Silje B ...
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Sørensen, Julie ...
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Vognild, Ylva H.
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Gjestad, Rolf
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show more...
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Öst, Lars-Göran
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Bjaastad, Jon F.
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Shirk, Stephen S ...
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Wergeland, Gro J ...
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show less...
- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Psychology
- Articles in the publication
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Journal of clini ...
- By the university
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Stockholm University