Comparing the predictive capacity of observed in-session resistance to self-reported motivation in cognitive behavioral therapy
Section snippets
Methods
Data for the present study derive from a larger randomized controlled trial (RCT) investigating the efficacy of adding a motivational interviewing (MI) pre-treatment, compared to no pre-treatment (4-week waiting period), prior to CBT for GAD (Westra, Arkowitz, & Dozois, 2009). For the evaluation of the capacity of each measure to predict homework compliance and outcome, the CBT alone group (no pre-treatment; N = 38) was used in order to avoid any influence of having received MI on these
Results
Client demographics and means and standard deviations for all measures are presented in Table 1. The sample was between the ages of 18 and 66, not engaged in concurrent psychotherapy, ethnically diverse, generally well-educated, had a chronic worry problem, and 63% had at least 1 other clinically significant diagnosis beyond GAD. Correlations between the various measures evaluated in the present study are presented in Table 2. No significant correlations were observed among the measures of
Discussion
Of the three measures of motivation evaluated in the present study (observed early resistance and two self-report measures: the Change Questionnaire, CQ and the Client Motivation for Therapy Scale, CMOTS), higher observed resistance in CBT session 1 was the most consistent and strongest predictor of both proximal (lower homework compliance) and distal (less worry reduction post-CBT and at one-year follow-up) outcomes in CBT. Higher levels of early resistance also significantly distinguished
Acknowledgements
This study was generously supported by a grant from the National Institute of Mental Health R34-MH072615 and a New Investigator Award from the Canadian Institute of Health Research awarded.
Much thanks to the outstanding resistance coders at York who were involved in the present study, Adi Aviram, Angela Kertes, Mariyam Ahmed, & Laura Connors.
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