Does the cognitive dispute of psychotic symptoms do harm to the therapeutic alliance?
We examined whether the cognitive dispute of psychotic symptoms has a negative impact on the course of the therapeutic alliance. Sixty-seven patients with persistent psychotic symptoms received either cognitive behavioral therapy (CBT) or supportive therapy. Questionnaire-based alliance ratings were repeatedly obtained throughout the course of therapy. Patient and therapist alliance ratings were examined separately. Data analyses comprised repeated measurement analyses of variance and cluster analytic procedures. Neither patient nor therapist alliance ratings showed a differential course throughout the treatments. This was despite the implementation of disputing strategies in later stages of CBT. Irrespective of the treatment condition a cluster with a positive alliance rating and a cluster with a poorer rating were found for therapist and patient ratings, respectively. Baseline symptoms and insight differentiated between the types of clusters. In conclusion, CBT-specific interventions that challenge psychotic symptoms do not necessarily negatively influence the course of the alliance.
Wittorf
Andreas
A
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany. andreas.wittorf@med.uni-tuebingen.de
Jakobi
Ute E
UE
Bannert
Kerstin K
KK
Bechdolf
Andreas
A
Müller
Bernhard W
BW
Sartory
Gudrun
G
Wagner
Michael
M
Wiedemann
Georg
G
Wölwer
Wolfgang
W
Herrlich
Jutta
J
Buchkremer
Gerhard
G
Klingberg
Stefan
S
D000328:Adult; D001364:Awareness; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003702:Delusions / Q000523:psychology* / Q000628:therapy*; D034462:Dissent and Disputes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D012944:Social Support; D011795:Surveys and Questionnaires