Therapeutic alliance, expressed emotion, and treatment outcome for anorexia nervosa in a family-based partial hospitalization program.
Adolescent therapeutic alliance has been found to be associated with improvements in eating disorder cognitions and with early weight gain. The current study assessed patient and parent therapeutic alliance, correlates of parent alliance, and relationship between alliance and treatment outcome. Fifty-six patients with anorexia nervosa completed measures of therapeutic alliance and eating disorder symptoms. Patients' parents completed measures of therapeutic alliance, expressed emotion, and psychopathology. Patients' alliance predicted cognitive and behavioral symptomatology at end of treatment (β=-0.39, p=0.001), though it was not related to changes in weight (β=0.12, p=0.377). Maternal hostility was associated with lower maternal alliance (r=-0.34, p=0.05). Findings suggest that maternal hostility should be addressed in treatment, and that patient alliance may be important in achieving psychological recovery from disordered eating.
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. Electronic address: reneedr@med.umich.edu.
Renee D
RD
Rienecke
Medical University of South Carolina, 135 Rutledge Ave., MSC 561, Charleston, SC 29425, USA. Electronic address: richmonr@musc.edu.
Rebekah
R
Richmond
Department of Psychiatry & Behavioral Sciences, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. Electronic address: j.lebow@med.miami.edu.
Jocelyn
J
Lebow
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D003631:Day Care, Medical; D019260:Expressed Emotion; D005196:Family Therapy; D005260:Female; D006801:Humans; D010290:Parents / Q000523:psychology*; D016896:Treatment Outcome; D015430:Weight Gain
Adolescents; Anorexia; Expressed emotion; Partial hospitalization; Therapeutic alliance