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The role of treatment delivery factors in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia

  • Treatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients’ interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists’ adherence (r = 0.54) and therapeutic alliance (r = 0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients’ interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r = 0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, areTreatment delivery factors (i.e., therapist adherence, therapist competence, and therapeutic alliance) are considered to be important for cognitive behavioral therapy (CBT) for panic disorder and agoraphobia (PD/AG). In the current study, four independent raters conducted process evaluations based on 168 two-hour videotapes of 84 patients with PD/AG treated with exposure-based CBT. Two raters evaluated patients’ interpersonal behavior in Session 1. Two raters evaluated treatment delivery factors in Session 6, in which therapists provided the rationale for conducting exposure exercises. At the 6-month follow-up, therapists’ adherence (r = 0.54) and therapeutic alliance (r = 0.31) were significant predictors of changes in agoraphobic avoidance behavior; therapist competence was not associated with treatment outcomes. Patients’ interpersonal behavior in Session 1 was a significant predictor of the therapeutic alliance in Session 6 (r = 0.17). The findings demonstrate that treatment delivery factors, particularly therapist adherence, are relevant to the long-term success of CBT for PD/AG.show moreshow less

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Metadaten
Author:Florian Weck, Florian Grikscheit, Volkmar Höfling, Anne Kordt, Alfons O. Hamm, Alexander L. Gerlach, Georg W. Alpers, Volker Arolt, Tilo Kircher, Paul Pauli, Winfried Rief, Thomas Lang
DOI:https://doi.org/10.1016/j.janxdis.2016.05.007
ISSN:0887-6185
ISSN:1873-7897
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=27235836
Parent Title (English):Journal of anxiety disorders
Publisher:Elsevier
Place of publication:Oxford
Document Type:Article
Language:English
Year of first Publication:2016
Year of Completion:2016
Release Date:2020/03/22
Tag:Interpersonal behavior; Panic disorder with agoraphobia; Therapeutic alliance; Therapist adherence; Therapist competence
Volume:42
Pagenumber:9
First Page:10
Last Page:18
Funder:German Research Foundation [WE 4654/4-2]; German Federal Ministry of Education and Research (BMBF) [01GV0614]
Peer Review:Referiert
Institution name at the time of publication:Humanwissenschaftliche Fakultät / Exzellenzbereich Kognitionswissenschaften