The relation between outcome expectation, therapeutic alliance, and outcome among depressed patients in group cognitive-behavioral therapy. (4th May 2018)

• Record Type: Journal Article
• Authors: Vîslă, Andreea; Constantino, Michael J.; Newkirk, Katie; Ogrodniczuk, John S.; Söchting, Ingrid
• Is Part Of: Psychotherapy research. Volume 28:Number 3(2018)
• Page Start: 446
• Page End: 456
• Publication Date: 2018-05-04
• Subjects: outcome expectation -- alliance -- outcome -- group CBT -- depression -- mediation; expectativa de resultado -- aliança -- resultado -- TCC em grupo -- depressão -- mediação; Ergebniserwartung -- Allianz -- Ergebnis -- Gruppen-KVT -- Depression -- Mediation; 治療效果期待 -- 同盟關係 -- 治療效果 -- CBT 組 -- 憂鬱 -- 中介; aspettativa di esito -- alleanza -- esito -- CBT di gruppo -- depressione -- mediazione; Psychotherapy -- Periodicals; Psychotherapy -- Research -- Periodicals; Psychotherapy -- Periodicals; Psychothérapie -- Périodiques; Psychothérapie -- Recherche -- Périodiques; 616.891405
• DOI: 10.1080/10503307.2016.1218089
• Languages: English
• ISSNs: 1050-3307

Abstract

Abstract: Objective: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy.Method: This study focused on such associative chains among 91 depressed outpatients who completed 10 weeks of group cognitive-behavioral therapy. We conducted simple and multiple mediation analyses, accounting for the nested data structure.Results: As predicted, we found: (i) The relations between baseline outcome expectation and both posttreatment anxiety and depression were mediated by alliance quality; (ii) the early therapy outcome expectation-posttreatment anxiety relation was mediated by mid-treatment alliance; (iii) the relation between early alliance and posttreatment interpersonal problems was mediated by during-therapy outcome expectation; and (iv) the relation between baseline outcome expectation and posttreatment interpersonal problems was mediated by two variables acting in turn, early alliance and during-therapy outcome expectation. All other tested models were not significant.Conclusions: Results suggest that bidirectional relations between outcome expectation and alliance, with both directions influencing outcome. Clinical and empirical implications are discussed.