title: The Role of Theory-Specific Techniques and Therapeutic Alliance in Promoting Positive Outcomes: Integrative Psychotherapy for World Trade Center Responders.
abstract: World Trade Center responders demonstrate high symptom burden, underscoring the importance of refining treatment approaches for this cohort. One method is examining the impact of therapy techniques on outcomes, and the interactions between technique and alliance on outcomes. This study a) examined the interaction of early treatment techniques on integrative psychotherapy outcomes and b) explored whether associations differed at varying levels of alliance. Twenty-nine adult responders diagnosed with partial or full posttraumatic stress disorder received outpatient psychotherapy and completed weekly measures of alliance, technique, and symptom distress. Analyses indicated significant interactions between 1) alliance and psychodynamic interventions on outcomes and 2) alliance and cognitive behavioral (CB) interventions on outcomes. Clients with high alliance had better outcomes when their therapist used fewer CB techniques. No meaningful differences were found between technique and outcomes for clients with lower alliance. These findings reiterate the critical roles technique and responsiveness to the alliance play in engendering successful outcomes.
authors.affiliation: *World Trade Center Health Program, New York University School of Medicine Clinical Center of Excellence, NY; and †Department of Counseling Psychology, University of Denver, Denver, CO.
authors.forename: Peter Tejas
authors.initials: PT
authors.lastname: Haugen
authors.forename: Aditi Sinha
authors.initials: AS
authors.lastname: Werth
authors.forename: Alyce Lauren
authors.initials: AL
authors.lastname: Foster
authors.forename: Jesse
authors.initials: J
authors.lastname: Owen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D060731:Emergency Responders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011369:Professional-Patient Relations; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome