Open Door Review

"#0!Z)%M$*D!2<<$2*70!2*&!(#0!6(23$<$(4!):!(#0%210B($7!)B(7)906!$*!(#0! (%02(90*(!):!&01%0660&!12($0*(6?!=!1%)7066E)B(7)90!6(B&4!

HB30%_!O>_!H0*%$7#_!S>_!8<2%M$*_!i>!G!I![+,-P^>!/647#)2*2<4($7!Y0%6B6!1647#)&4*29$7!(#0%214!:)%! &01%066$)*?!=!(#%00E402%!:)<<)ZEB1!6(B&4>! '(A?-)@,#AO&bgpGmO !-P+E-]\>! HB30%_!O>_!p$990%92**_!i>_!H0*%$7#_!S>!G!I![+,-+^>!8)912%$6)*!):!7)D*$($Y0E30#2Y$)B%!(#0%214!Z$(#! 1647#)2*2<4($7!2*&!1647#)&4*29$7!(#0%214!:)%!&01%0660&!12($0*(6รก=!(#%00E402%!:)<<)ZEB1!6(B&4>! i%),(?-#)!,& !j#&'(A?-"("$@,)(?-%&Z%*)f)+&>+*&'(A?-",-%#@:)%O&Je [P^_!+\\EP-g>! >-001(3! In a process-outcome design comparing different forms of psychotherapy (psychoanalytic psychotherapy, psychodynamic psychotherapy, and cognitive-behavioral therapy) the study investigated whether the working alliance has differential impact on outcomes and their stability. The working alliance is viewed as a mediator variable serving to explain the treatment process and its influence on different outcomes. We assume the working alliance to be one of three components constituting the therapeutic relationship that is, beyond the working alliance, the real relationship between patient and therapist and the transference. Meta-analyses suggest working alliance as a robust predictor of different outcomes, however, the predictive power is relatively low, explaining only 7% of the outcome variance. Nevertheless, the working alliance can be regarded as a substantial predictor, taking into account that other curative factors explain rarely more than 15% of outcome variance. The patient sample is derived from the prospective and partly randomized MPS sample consisting of 100 patients (intent-to-treat sample) who met the DSM-IV criteria for major depressive disorder (psychoanalytic psychotherapy=35, psychodynamic psychotherapy=31, cognitive-behavioral therapy=34); the completer sample comprises 85 patients. Therapy sessions of each patient have been audiotaped but 13 cases had to be excluded due to low audio quality (psychoanalytic psychotherapy=26, psychodynamic psychotherapy=24, cognitive-behavioral therapy=22). Patients were assessed at pretreatment, at post-treatment and at follow-up each year after treatment termination up to three years. Self-rating questionnaires important for the study described here are the Beck-Depression Inventory (BDI) and the Inventory of Interpersonal Problems (IIP-short version). As Stiles and Goldsmith (2010) recommended, we decided to measure the process in a multimodal way including patients, therapists and external rater assessments. For measuring the working alliance we choose the Working Alliance Inventory (WAI-observer rating short form). The WAI is a trans- theoretical instrument suitable for different treatment approaches, based on three dimensions: agreement on tasks agreement on goals development of bond. Measurement points for WAI are 6 and 12 months after beginning of treatment; ratings are performed by trained raters. As a second process measure we use the Helping Alliance Questionnaire (patient and therapist version [HAQ-P and HAQ-T]). The inventory consists of 11 items assessing two aspects of the therapeutic working alliance: perceived helpfulness by the therapist

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