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The Therapeutic Alliance in Cognitive Therapy for Depression in Combination with Antidepressant Medication: Relations to Subsequent Symptom Change and Treatment Retention

Ryan, Elizabeth

Abstract Details

2009, Master of Arts, Ohio State University, Psychology.
While Cognitive Therapy (CT) has been established as an efficacious treatment for depression, less is known about the exact mechanisms by which CT achieves its effect. The therapeutic alliance is one of the most widely studied process variables across treatments and results suggest that there is a small, but consistent positive association between alliance and outcome. The results, however, are less clear when the alliance is studied within the context of CT specifically. Methodological differences may partly explain these discrepant findings, highlighting the need to address the most appropriate methodological design when studying the alliance-outcome relationship. Specifically, including only subsequent change in the analyses ensures that the alliance is not confounded with prior symptom improvement. In the current study, alliance was rated by independent observers during the first three sessions of CT within a sample (N = 176) of patients with depression undergoing a course of CT in combination with anti-depressant medication. The overall alliance was predictive (at the level of a non-significant trend) of subsequent early symptom improvement, with the subscale reflecting agreement on treatment tasks emerging as a significant predictor, as well as significantly predicting the rate of improvement over a 16 week period of treatment. The alliance was not found to be a predictor of drop-out rate across the course of treatment. Overall, results suggest while the alliance may be a significant determinant of symptom change, its effects are small.
Daniel Strunk (Advisor)
Jennifer Cheavens (Committee Member)
Steven Beck (Committee Member)
76 p.

Recommended Citations

Citations

  • Ryan, E. (2009). The Therapeutic Alliance in Cognitive Therapy for Depression in Combination with Antidepressant Medication: Relations to Subsequent Symptom Change and Treatment Retention [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1262278719

    APA Style (7th edition)

  • Ryan, Elizabeth. The Therapeutic Alliance in Cognitive Therapy for Depression in Combination with Antidepressant Medication: Relations to Subsequent Symptom Change and Treatment Retention. 2009. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1262278719.

    MLA Style (8th edition)

  • Ryan, Elizabeth. "The Therapeutic Alliance in Cognitive Therapy for Depression in Combination with Antidepressant Medication: Relations to Subsequent Symptom Change and Treatment Retention." Master's thesis, Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1262278719

    Chicago Manual of Style (17th edition)