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Therapists’ and clients’ perceptions of each other and working alliance in the behavioral treatment of panic disorder with agoraphobia
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
2007 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 7, no 3, 320-328 p.Article in journal (Refereed) Published
Abstract [en]

Fifty-nine patients who fulfilled criteria for a primary diagnosis of panic disorder with moderate to severe agoraphobia were treated with 16 sessions of behavioral therapy. The study investigated the relationship between therapists' and clients' perception of each other, working alliance, and outcome. There was initially a low correspondence between therapist and client perceptions but a growing consensus during treatment. This was most pronounced regarding high ratings of therapist qualities and the perception of the client as attractive. Clients' perceptions showed virtually zero correlation with outcome regardless of time. Therapist perception of client as showing active participation and goal direction yielded positive correlations with outcome at posttreatment and follow-up from Session 4 and throughout treatment. No significant relation between working alliance and outcome was found apart from the fact that those who improved during follow-up rated the alliance significantly higher than those who did not improve.

Place, publisher, year, edition, pages
2007. Vol. 7, no 3, 320-328 p.
National Category
Psychology
Identifiers
URN: urn:nbn:se:su:diva-23618DOI: 10.1080/10503300600650852OAI: oai:DiVA.org:su-23618DiVA: diva2:193458
Available from: 2005-03-14 Created: 2005-03-14 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Behavioral Treatments of Panic Disorder with Agoraphobia: Treatment Process and Determinants of Change
Open this publication in new window or tab >>Behavioral Treatments of Panic Disorder with Agoraphobia: Treatment Process and Determinants of Change
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present dissertation comprises four empirical studies within the area of behavioral treatment of panic disorder with agoraphobia. The focus is on studying issues pertaining to outcome, treatment process and determinants of change. The first study is a randomized controlled treatment study of 73 patients undergoing 16 sessions of either exposure in vivo (E), or cognitive behavior therapy (CBT). Both treatments showed clear improvements at post-treatment that were well maintained at 1-year follow up, and there were no significant differences between the treatments.

The second study concerned prediction of outcome in the same sample. From a variety of pre-treatment characteristics severity of avoidance was the one most related to outcome. Most predictors were found unrelated. Two approaches of prediction were also compared: treating outcome as a categorical vs. continuous variable. The different approaches yielded a somewhat dissimilar picture of the impact of pre-treatment severity of avoidance. The third study examined different aspects of the therapeutic relationship, and their relation to outcome. Clients’ perceptions of therapists and their ratings of the working alliance were generally not related to outcome at any point. On the other hand, therapists’ perceptions of patients as showing goal-direction and active participation were related to outcome from early on in therapy. The fourth study examined different aspects of change. It was found that change in indices of the frequency of panic attacks was not closely related to change in agoraphobic avoidance at post-treatment. Change in avoidance was also more related to other aspects of outcome. At one-year follow-up, a more unitary picture, regarding the different aspects of change was observed.

Place, publisher, year, edition, pages
Stockholm: Psykologiska institutionen, 2005
Keyword
Panic disorder with agoraphobia, cognitive-behavior therapy, exposure in vivo, outcome prediction, therapeutic relationship, working alliance
National Category
Psychology
Identifiers
urn:nbn:se:su:diva-404 (URN)91-7155-022-4 (ISBN)
Public defence
2005-04-08, David Magnussonsalen (U31), hus 8, Frescati hagväg 8, Stockholm, 10:00
Opponent
Supervisors
Available from: 2005-03-14 Created: 2005-03-14Bibliographically approved

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