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IF 3.4 2区医学 Q2 PSYCHIATRY

BMC Psychiatry Pub Date : 2025-01-13 DOI:10.1186/s12888-024-06410-x

Anne Grass, Rita Rosner, Angelina Ciner, Babette Renneberg, Regina Steil

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引用次数: 0

摘要

背景：在各种临床人群中，治疗联盟的加强与治疗效果的改善有关。然而，在创伤后应激障碍（PTSD）的年轻患者中，这种关联还缺乏证据。因此，我们对患有创伤后应激障碍（PTSD）的青少年和年轻人在接受发展适应性认知加工疗法（D-CPT）期间治疗联盟的发展情况进行了调查，以回答治疗联盟与症状减轻之间是否存在联系的问题：方法：通过多层次建模分析了由患者及其治疗师评定的治疗联盟每周评估结果，以及 D-CPT 随机对照试验（RCT）中创伤后应激障碍症状的严重程度。样本包括 n = 39 名 14-21 岁、有性虐待和/或身体虐待史的患者：结果：在 D-CPT 治疗过程中，治疗联盟有所增加。患者和治疗师对治疗联盟的评价密切相关（r = .512，p 讨论）：治疗联盟在年轻患者的 D-CPT 治疗中起着至关重要的作用，有助于在治疗过程中减轻症状的严重程度。治疗师必须优先发展稳固的联盟关系，并寻求患者的反馈。研究结果表明，患者的看法往往与治疗师的评估不同，而在样本中，患者的看法对决定治疗成功与否更为重要。要进一步研究联盟与治疗结果之间的关系，还需要进行更大规模的样本研究，并对联盟进行更多的独立评估：该试验已于 2013 年 3 月 18 日在德国临床试验注册中心（DRKS00004787）注册，https://www.drks.de/DRKS00004787 。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Therapeutic alliance during trauma focused treatment in adolescent and young adult patients with PTSD.

Background: Greater therapeutic alliance has been associated with an improved treatment outcome in various clinical populations. However, there is a lack of evidence for this association in posttraumatic stress disorder (PTSD) in young patients. We therefore investigated the development of the therapeutic alliance during Developmentally adapted cognitive processing therapy (D-CPT) in adolescents and young adults with PTSD following abuse to answer the question whether there was a connection between the therapeutic alliance and symptom reduction.

Methods: Weekly assessments of therapeutic alliance, rated by patients and their therapists, as well as PTSD symptom severity from a randomized controlled trial (RCT) of D-CPT were analyzed with multilevel modelling. The sample consisted of n = 39 patients aged 14-21 with a history of sexual and/or physical abuse.

Results: Therapeutic alliance increased during D-CPT. The ratings of the therapeutic alliance by patients and therapists were strongly correlated (r = .512, p < .01); however, at session level, there was a significant difference between the patients' and their therapists' alliance assessments. Patients with a higher perceived therapeutic alliance showed a greater reduction in self-reported symptoms over the course of therapy, compared to patients with lower alliance ratings. However, this only applied to the therapeutic alliance assessed by the patients.

Discussion: The therapeutic alliance plays a crucial role in D-CPT with young patients, contributing to a reduction in symptom severity over the course of treatment. It is essential that therapists prioritize the development of a strong alliance and seek feedback from their patients. The results suggest that patients' perceptions, which often differ from therapists' assessments, were more important in determining treatment success in the sample. Studies with larger samples sizes and additional independent ratings of alliance are needed to further examine the alliance-outcome link.

Trial registration: The trial was registered at the German Clinical Trial Registry, DRKS00004787, 18 March 2013, https://www.drks.de/DRKS00004787 .

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来源期刊

BMC Psychiatry 医学-精神病学

CiteScore

5.90

自引率

4.50%

发文量

716

审稿时长

3-6 weeks

期刊介绍： BMC Psychiatry is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology.