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15-11-2018 | Original Article

Pre-treatment CBT-Mindedness Predicts CBT Outcome

Auteurs: Lauren F. McLellan, Lexine A. Stapinski, Lorna Peters

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2019

Abstract

While CBT is considered efficacious for a range of mental health conditions, identifying pre-treatment predictors of differential response to CBT is an important direction for research. This study investigated whether pre-treatment attitudes aligned with cognitive behaviour therapy (CBT) (termed CBT-mindedness) predicts CBT outcome within a clinical sample of adults diagnosed with social phobia (N = 50). Pre-treatment CBT-mindedness, measured by the CBT Suitability Scale, was found to predict treatment outcome immediately and 3 months following treatment. Higher CBT-mindedness was associated with lower clinician-rated diagnostic severity and client self-reported social anxiety symptoms following CBT. CBT-mindedness predicted self-reported, but not clinician-reported severity, even when controlling for existing client-factors that predict outcome (expectancy for symptom change and treatment credibility). However, CBT-mindedness was not associated with therapy session attendance. Results suggest that pre-treatment CBT-mindedness is a promising predictor of CBT outcome. Clinical implications for this predictor of CBT response are discussed.

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While we would expect CBT-mindedness to predict outcome in clients seeking treatment for any disorder, the current study utilised a sample of adults seeking treatment for social anxiety disorder, a common and impairing anxiety disorder.

Australian and New Zealand Clinical Trials Registry [Internet]: Sydney (NSW): Centre for Emotional Health, Macquarie University (Australia); 2010—Identifier ACTRN12610000469011. Efficacy of motivational interviewing prior to cognitive behavioural treatment for social phobia; 2010 June 9; [1 page]. Available from http://www.anzctr.org.au/ACTRN12610000469011.aspx.

Mixed model analysis comparing the two treatment groups (preparatory motivational interviewing or no preparatory treat) across time on CSR and SIAS showed a significant main effect of group [F(1, 43.32 = 8.80, p = .005 and F(1, 46.18) = 5.63, p = .022) respectively], time [F(2, 39.14) = 50.91, p < .001 and F(2, 39.68) = 61.65, p < .001 respectively], and group X time interaction [F(2, 39.14) = 11.53, p < .001 and F(2, 39.68) = 3.96, p = .027 respectively]. Pairwise comparisons between the estimated means for each group at the three timepoints, using Bonferroni adjustment for multiple comparisons, showed no difference between groups at pre-treatment (CSR: p = .932, SIAS: p = .262), a trend towards significance at post-treatment (CSR: p = .082, SIAS: p = .063) and a significant reduction in scores for the CBT + preparatory group compared to CBT alone group at follow-up (CSR: p < .001, SIAS: p = .004).

This analysis is marginally significant using the imputed dataset. See the Online Appendix for results.

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Titel: Pre-treatment CBT-Mindedness Predicts CBT Outcome
Auteurs: Lauren F. McLellan
Lexine A. Stapinski
Lorna Peters
Publicatiedatum: 15-11-2018
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 2/2019
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9977-7

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