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09-01-2018 | ORIGINAL PAPER

The Role of Working Alliance in CBT and MBSR for Social Anxiety Disorder

Auteurs: Hooria Jazaieri, Philippe R. Goldin, James J. Gross

Gepubliceerd in: Mindfulness | Uitgave 5/2018

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Abstract

Common factors are understood to play an important role in many therapeutic interventions. What is not yet clear is whether the relative importance of common factors in therapeutic interventions varies as a function of treatment type and/or disorder. In this study, we were specifically interested in the common factor of working alliance. We randomized adults with generalized social anxiety disorder (SAD) to 12 weeks of small group cognitive behavioral therapy (CBT; N = 46, 58.7% female, average age 33.41 ± 7.62 years) and 12 weeks of small group mindfulness-based stress reduction (MBSR; N = 40, 57.5% female, average age: 32.77 ± 7.94). We measured social anxiety clinical symptom severity using the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR) scale at baseline, post-treatment, 6 months, and 12 months post-treatment. We also measured the participant’s self-reported working alliance with their therapist/instructor at session 5. Results indicated that in the CBT group, working alliance measured at session 5 was not predictive of clinical symptom severity (LSAS-SR) at post-intervention (p > .27), 6 months (p > .39), or 12 months (p > .24) post-treatment. By contrast, in the MBSR group, working alliance measured at session 5 was predictive of clinical symptom severity at post-intervention (∆R2 = .11), 6 months (∆R2 = .15), and 12 months (∆R2 = .18) post-treatment. Follow-up analyses indicated that when compared to CBT, greater Working Alliance Inventory during MBSR was meaningful in that it predicted long-term (12-month follow-up) social anxiety symptom reduction (∆R2 = .12). These findings suggest that the importance of working alliance may vary by type of intervention, at least in the case of SAD.
Literatuur
go back to reference Alden, L. E. (2001). Interpersonal perspectives on social phobia. In W. R. Crozier & L. E. Alden (Eds.), International handbook of social anxiety: concepts, research and interventions relating to the self and shyness (pp. 381–404). New York: Wiley. Alden, L. E. (2001). Interpersonal perspectives on social phobia. In W. R. Crozier & L. E. Alden (Eds.), International handbook of social anxiety: concepts, research and interventions relating to the self and shyness (pp. 381–404). New York: Wiley.
go back to reference Alden, L. E., & Taylor, C. T. (2004). Interpersonal processes in social phobia. Clinical Psychology Review, 24, 857–882.CrossRefPubMed Alden, L. E., & Taylor, C. T. (2004). Interpersonal processes in social phobia. Clinical Psychology Review, 24, 857–882.CrossRefPubMed
go back to reference Alsubaie, M., Abbott, R., Dunn, B., Dickens, C., Keil, T., Henley, W., & Kuyken, W. (2017). Mechanisms of action in mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in people with physical and/or psychological conditions: a systematic review. Clinical Psychology Review, 55, 74–91. https://doi.org/10.1016/j.cpr.2017.04.008.CrossRefPubMed Alsubaie, M., Abbott, R., Dunn, B., Dickens, C., Keil, T., Henley, W., & Kuyken, W. (2017). Mechanisms of action in mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) in people with physical and/or psychological conditions: a systematic review. Clinical Psychology Review, 55, 74–91. https://​doi.​org/​10.​1016/​j.​cpr.​2017.​04.​008.CrossRefPubMed
go back to reference Andersson, G., Paxling, B., Wiwe, M., Vernmark, K., Felix, C. B., Lundborg, L., & Carlbring, P. (2012). Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder. Behavior Research and Therapy, 50, 544–550. https://doi.org/10.1016/j.brat.2012.05.003.CrossRef Andersson, G., Paxling, B., Wiwe, M., Vernmark, K., Felix, C. B., Lundborg, L., & Carlbring, P. (2012). Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder. Behavior Research and Therapy, 50, 544–550. https://​doi.​org/​10.​1016/​j.​brat.​2012.​05.​003.CrossRef
go back to reference American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
go back to reference Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
go back to reference Bordin, E. S. (1980). Of human bonds that bind or free. Paper presented at the annual meeting of the Society for Psychotherapy Research, Pacific Grove, California. Bordin, E. S. (1980). Of human bonds that bind or free. Paper presented at the annual meeting of the Society for Psychotherapy Research, Pacific Grove, California.
go back to reference Davison, G. C., & Lazarus, A. A. (1995). The dialectics of science and practice. In S. C. Hayes & V. M. Follette (Eds.), Scientific standards of psychological practice: Issues and recommendations (pp. 95–120). Reno, NV: Context Press. Davison, G. C., & Lazarus, A. A. (1995). The dialectics of science and practice. In S. C. Hayes & V. M. Follette (Eds.), Scientific standards of psychological practice: Issues and recommendations (pp. 95–120). Reno, NV: Context Press.
go back to reference DeRubeis, R. J., & Feeley, M. (1990). Determinants of change in cognitive therapy for depression. Cognitive Therapy and Research, 14, 469–482.CrossRef DeRubeis, R. J., & Feeley, M. (1990). Determinants of change in cognitive therapy for depression. Cognitive Therapy and Research, 14, 469–482.CrossRef
go back to reference DiNardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: lifetime version (ADIS-IV-L). New York, NY: Oxford University Press. DiNardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: lifetime version (ADIS-IV-L). New York, NY: Oxford University Press.
go back to reference Dobson, K. S., & Shaw, B. F. (1988). The use of treatment manuals in cognitive therapy: experience and issues. Journal of Consulting and Clinical Psychology, 56, 673–680.CrossRefPubMed Dobson, K. S., & Shaw, B. F. (1988). The use of treatment manuals in cognitive therapy: experience and issues. Journal of Consulting and Clinical Psychology, 56, 673–680.CrossRefPubMed
go back to reference Feeley, M., DeRubeis, R. J., & Gelfand, L. A. (1999). The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 67, 578–582.CrossRefPubMed Feeley, M., DeRubeis, R. J., & Gelfand, L. A. (1999). The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 67, 578–582.CrossRefPubMed
go back to reference Garfield, S. L. (1996). Some problems associated with “validated” forms of psychotherapy. Clinical Psychology: Science and Practice, 3, 218–229. Garfield, S. L. (1996). Some problems associated with “validated” forms of psychotherapy. Clinical Psychology: Science and Practice, 3, 218–229.
go back to reference Goldfried, M. R., & Davison, G. C. (1994). Clinical behavior therapy (exp ed.). New York: Wiley. Goldfried, M. R., & Davison, G. C. (1994). Clinical behavior therapy (exp ed.). New York: Wiley.
go back to reference Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy. New York: Guilford Press. Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy. New York: Guilford Press.
go back to reference Heimberg, R. G., & Becker, R. E. (2002). Cognitive-behavioral group therapy for social phobia: basic mechanisms and clinical strategies. New York: Guilford Press. Heimberg, R. G., & Becker, R. E. (2002). Cognitive-behavioral group therapy for social phobia: basic mechanisms and clinical strategies. New York: Guilford Press.
go back to reference Hope, D., Heimberg, R., & Turk, C. (2010). Managing social anxiety: a cognitive-behavioral therapy approach (2nd ed.). New York, NY: Oxford University Press. Hope, D., Heimberg, R., & Turk, C. (2010). Managing social anxiety: a cognitive-behavioral therapy approach (2nd ed.). New York, NY: Oxford University Press.
go back to reference Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counseling Psychology, 38, 139–149.CrossRef Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counseling Psychology, 38, 139–149.CrossRef
go back to reference Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The heart and soul of change: What works in therapy? Washington, DC: American Psychological Association.CrossRef Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The heart and soul of change: What works in therapy? Washington, DC: American Psychological Association.CrossRef
go back to reference Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte.
go back to reference Lambert, M. J. (1992). Psychotherapy outcome research: implications for integrative and eclectic therapists. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94–129). New York: Basic Books. Lambert, M. J. (1992). Psychotherapy outcome research: implications for integrative and eclectic therapists. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94–129). New York: Basic Books.
go back to reference Liebowitz, M. R. (1987). Social phobia. Modern Problems in Pharmacopsychiatry, 22, 141–173. Liebowitz, M. R. (1987). Social phobia. Modern Problems in Pharmacopsychiatry, 22, 141–173.
go back to reference Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.
go back to reference Linehan, M. M. (2015). DBT skills training manual (2nd ed.). New York: Guilford Press. Linehan, M. M. (2015). DBT skills training manual (2nd ed.). New York: Guilford Press.
go back to reference Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.CrossRefPubMed Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.CrossRefPubMed
go back to reference Miller, S. D., Duncan, B. L., & Hubble, M. A. (1997). Escape from Babel: toward a unifying language for psychotherapy practice. New York: Norton. Miller, S. D., Duncan, B. L., & Hubble, M. A. (1997). Escape from Babel: toward a unifying language for psychotherapy practice. New York: Norton.
go back to reference Raue, P. J., & Goldfried, M. R. (1994). Therapeutic alliance in cognitive-behavior therapy. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory, research and practice (pp. 131–152). New York: Wiley. Raue, P. J., & Goldfried, M. R. (1994). Therapeutic alliance in cognitive-behavior therapy. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory, research and practice (pp. 131–152). New York: Wiley.
go back to reference Rogers, C. R. (1951). Client-centered therapy: its current practice, implications and theory. London: Constable. Rogers, C. R. (1951). Client-centered therapy: its current practice, implications and theory. London: Constable.
go back to reference Rosenzweig, S. (1936). Some implicit common factors in diverse methods in psychotherapy. American Journal of Orthopsychiatry, 6, 412–415. Rosenzweig, S. (1936). Some implicit common factors in diverse methods in psychotherapy. American Journal of Orthopsychiatry, 6, 412–415.
go back to reference Rytwinski, N. K., Fresco, D. M., Heimberg, R. G., Coles, M. E., Liebowitz, M. R., Cissell, S.,. .. Hofmann, S. G. (2009). Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depression and Anxiety, 26, 34–38. doi:https://doi.org/10.1002/da.20503.CrossRefPubMed Rytwinski, N. K., Fresco, D. M., Heimberg, R. G., Coles, M. E., Liebowitz, M. R., Cissell, S.,. .. Hofmann, S. G. (2009). Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depression and Anxiety, 26, 34–38. doi:https://​doi.​org/​10.​1002/​da.​20503.CrossRefPubMed
go back to reference Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA: New Harbinger. Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA: New Harbinger.
go back to reference Woody, S. R., & Adessky, R. S. (2002). Therapeutic alliance, group cohesion, and homework compliance during cognitive-behavioral group treatment of social phobia. Behavior Therapy, 33, 5–27.CrossRef Woody, S. R., & Adessky, R. S. (2002). Therapeutic alliance, group cohesion, and homework compliance during cognitive-behavioral group treatment of social phobia. Behavior Therapy, 33, 5–27.CrossRef
Metagegevens
Titel
The Role of Working Alliance in CBT and MBSR for Social Anxiety Disorder
Auteurs
Hooria Jazaieri
Philippe R. Goldin
James J. Gross
Publicatiedatum
09-01-2018
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 5/2018
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-017-0877-9