Research Institute, Modum Bad Psychiatric Center.
Department of Psychology, University of Oslo.
J Consult Clin Psychol. 2024 Sep;92(9):594-606. doi: 10.1037/ccp0000853. Epub 2023 Sep 28.
In this naturalistic study we aimed to investigate the relationships between two central change processes (affective and cognitive) and two common relationship factors ("Confidence in the therapist" and "Confidence in the treatment"), which have been shown to impact outcomes in a clinical context. We also investigated whether these interrelationships varied across treatment orientations (i.e., cognitive or psychodynamic focused).
The sample consisted of 631 patients with a primary anxiety or depressive disorder who were admitted to an inpatient program and treated with psychotherapy. The data consisted of weekly measures of cognitive (i.e., "rumination") and affective (i.e., "problems with emotional clarity") change processes as well as scores on Confidence in the therapist and Confidence in the treatment and symptom distress. A multivariate version of the latent curve model with structured residuals was used to investigate the of week-to-week changes in all variables.
Initial analyses established that both problems with emotional clarity and rumination predicted symptom distress. Further, we found that higher Confidence in the therapist predicted higher emotional clarity (but not lower rumination) whereas higher Confidence in the treatment predicted lower rumination (but did not affect emotional clarity). Post hoc analyses found that these interrelationships varied across treatment orientation (i.e., cognitive vs. psychodynamic).
The results indicate that patients' experience of the therapist is associated with change processes, and that patients' experience of the coherence and meaningfulness of treatment, on the other hand, is associated with change processes. Implications for clinical practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
在这项自然主义研究中，我们旨在探讨两个核心变化过程（情感和认知）与两个常见的关系因素（“对治疗师的信心”和“对治疗的信心”）之间的关系，这些因素已在临床环境中被证明会影响治疗结果。我们还调查了这些相互关系是否因治疗取向（即认知或心理动力学焦点）而异。
该样本包括 631 名患有原发性焦虑或抑郁障碍的患者，他们被收治在住院治疗计划中，并接受心理治疗。数据包括每周对认知（即“反刍”）和情感（即“情绪清晰度问题”）变化过程的测量，以及对治疗师信心和治疗信心以及症状困扰的评分。使用具有结构化残差的潜在曲线模型的多元版本来调查所有变量的每周变化。
初步分析表明，情绪清晰度问题和反刍都预测了症状困扰。此外，我们发现对治疗师的信心越高，情绪清晰度越高（但反刍越低），而对治疗的信心越高，反刍越低（但不影响情绪清晰度）。事后分析发现，这些相互关系因治疗取向（即认知与心理动力学）而异。
结果表明，患者对治疗师的体验与认知变化过程有关，而另一方面，患者对治疗的连贯性和意义的体验与情感变化过程有关。讨论了对临床实践的影响。（PsycInfo 数据库记录（c）2024 APA，保留所有权利）。
