Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents

Autor: Loos, S., Tutus, D., Kilian, R., Goldbeck, L.
Rok vydání: 2020
Předmět:
聚焦创伤认知行为疗法 (TF-CBT)
Trastorno de estrés postraumático (TEPT)
创伤后应激障碍症状 (PTSS)
Adolescent
trauma-focused cognitive behavioural therapy (TF-CBT)
RC435-571
创伤后应激障碍 (PTSD)
Kind
Posttraumatisches Stresssyndrom
Kognitive Verhaltenstherapie
Terapia cognitivo-conductual centrada en el trauma (TF-CBT)
Adolescents
Stress Disorders
Post-Traumatic
ddc:150
• This article investigated if alliance ratings from young patients
therapists and caregivers are associated with a reduction of Posttraumatic Stress Symptoms in trauma-focused treatment (Tf-CBT).• Advanced statistical methods were used considering the nested
non-independent data structure (therapists develop alliances to several clients and caregivers).• We found evidence for a significant impact for both the therapist to caregiver and the patient to therapist alliance on decreasing PTSS of patients over time
ddc:610
Posttraumatic stress symptoms (PTSS)
Child
Children
Psychiatry
Clinical Research Article
DDC 150 / Psychology
Traumafocused cognitive behavioural therapy (TF-CBT)
Posttraumatic stress disorder (PTSD)
Working alliance
Cognitive behavioral therapy
工作同盟 (WA)
Children/adolescents
Jugend
niños y adolescentes
儿童和青少年
Síntomas de estrés postraumático (PTSS)
DDC 610 / Medicine & health
Alianza de trabajo (WA)
Zdroj: European Journal of Psychotraumatology
European Journal of Psychotraumatology, Vol 11, Iss 1 (2020)
DOI: 10.6084/m9.figshare.12295919.v1
Popis: Background: Caregivers play a key role in the success of trauma-focused cognitive behavioural therapy (TF-CBT). Yet, the effect of their alliance on treatment outcomes besides the other parties in treatment has hardly been studied. Objective: This study examined the working alliance (WA) of therapists, patients and caregivers in TF-CBT and its contribution on treatment outcome over time. Methods: N = 76 children and adolescents (mean age = 12.66 years, range 7–17, M/F ratio: .43) participated in the TF-CBT arm of a randomized controlled trial. The WA was assessed with the Working Alliance Inventory Short Version (WAI-S) at two measurement points, while symptom level of posttraumatic stress symptoms (PTSS) was assessed with the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Paired sample t-tests, intraclass correlations (ICC), and mixed-effects regression models for longitudinal data were performed. Results: The alliance rating was high across all informants, with caregivers achieving the highest rating. The average level of cross-informant agreement on the alliance was low between therapists and caregivers (ICC = .26) and moderate between therapists and patients (ICC =.65). A significant contribution of an alliance improvement to the reduction of PTSS over time was found in each of the two tested models: therapists with patients model (b = .682) and therapists with caregivers model (b = .807). However, these effects were not detected with all four perspectives in one comprehensive model. Conclusion: In summary, the potential of caregivers’ views should receive more attention in the therapeutic process of trauma-focused therapy.
publishedVersion
Databáze: OpenAIRE
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