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History of sexual assault in schizophrenia has been suggested as a risk factor for psychosis and a graver course of illness. One possibility is that a history of this type of trauma affects responses to treatment by forming a barrier to a therapeutic alliance. To explore this possibility, we compared monthly ratings of therapeutic alliance for clients with schizophrenia with (n = 9) and without (n = 31) a history of sexual assault across 6 months of cognitive behavior therapy. Ratings were collected from clients and therapists and compared using a repeated measures analysis of variance controlling for level of positive symptoms. Results revealed that clients with a sexual trauma history produced lower overall rating of therapeutic alliance than clients without such a history. Therapist ratings of therapeutic alliance between both groups were not significantly different. Results suggest treatment may need to consider trauma histories as a barrier to therapeutic alliance.
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Blankertz, L. E., Cnaan, R. A., & Freedman, E. (1993). Childhood risk factors in dually diagnosed homeless adults. Social Work, 38, 587–596. PubMed
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy Theory and Research, 16, 252–260. CrossRef
Callahan, K. L., Price, J. L., & Hilsenroth, M. J. (2005). Psychological assessment of adult survivors of childhood sexual abuse within a naturalistic clinical sample. Journal of Personality Assessment, 80(2), 173–184. CrossRef
Chu, J. A. (1992). The therapeutic roller coaster: Dilemmas in the treatment of childhood abuse survivors. Journal of Psychotherapy Practice and Research, 1, 351–370.
Chu, J. A. (1998). Rebuilding shattered lives: The responsible treatment of complex post-traumatic and dissociative disorders. New York: Wiley.
Conus, P., Cotton, S., Schimmelmann, B. G., McGorry, P. D., & Lambert, M. (in press). Pretreatment and outcome correlates of sexual and physical trauma in an epidemiological cohort of first-episode psychosis. Schizophrenia Bulletin.
Courtois, C. A. (1988). Healing the incest wound: Adult survivors in therapy. New York: W.W. Norton.
Courtois, C. A. (1999). Recollections of sexual abuse: Treatment principles and guidelines. New York: W.W. Norton.
Cusak, K. J., Frueh, B. C., & Brady, K. T. (2004). Trauma history screening in a community mental health center. Psychiatric Services, 55, 157–162. CrossRef
Dalenberg, C. J. (2000). Countertransference and the treatment of trauma. Washington DC: American Psychological Association. CrossRef
Davies, J. M., & Frawley, M. G. (1994). Treating the adult survivor of childhood sexual abuse: A psychoanalytic perspective. New York: Basic Books.
Frank, A. F., & Gunderson, J. G. (1990). The role of the therapeutic alliance in the treatment of schizophrenia. Archives of General Psychiatry, 47, 228–236. PubMed
Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36(2), 223–233. 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
Kay, S. R., Fiszbein, A., & Opler, L. (1987). The positive and negative syndrome scale for schizophrenia. Schizophrenia Bulletin, 13, 261–276. PubMed
Krupnick, J. L., Sotsky, S., Elkin, I., Simmens, S., Moyer, J., Watkins, J., et al. (1996). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 64(3), 532–539. PubMedCrossRef
Lacro, J. P., Dunn, L. B., Dolder, C. R., Leckband, S. B., & Jeste, D. V. (2002). Prevalence of and risk factor for medication nonadherence in patients with schizophrenia: A comprehensive review of recent literature. Journal Clinical Psychiatry, 63, 892–909. CrossRef
Lysaker, P. H., & Gumley, A. (2010). Psychotherapeutic and relational processes and the development of metacognitive capacity following five years of individual psychotherapy: A case study of a man with psychotic symptoms. Psychosis, 2(1), 70–78. CrossRef
Lysaker, P. H., Hunter, N. L., Strasburger, A. M., & Davis, L. W. (2005b). Reported history of child sexual abuse in schizophrenia: Associations with heightened levels of hallucinations and anxiety and poorer participation over four months in vocational rehabilitation. Journal of Nervous and Mental Disease, 193, 790–795. PubMedCrossRef
Miller, L. (2008). Counseling crime victims: Practical strategies for mental health professionals. New York: Springer Publishing Company.
Milne, D., Claydon, T., Blackburn, I. M., James, I., & Sheikh, A. (2001). Rationale for a new measure of competence in therapy. Behavioral and Cognitive Psychotherapy, 29, 21–33. CrossRef
Mueser, K. T., Salyers, M. P., Rosenberg, S. D., Goodman, L. A., Essock, S. M., Osher, F. C., et al. (2004). Interpersonal trauma and posttraumatic stress disorder in patients with severe mental illness: Demographics, clinical, and health correlates. Schizophrenia Bulletin, 30, 45–57. PubMed
Paivio, S. C., & Patterson, L. A. (1999). Alliance development in therapy for resolving child abuse issues. Psychotherapy, 36, 343–354. CrossRef
Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: W.W. Norton.
Read, J., Perry, B. D., & Moskowitz, A. (2001). The contribution of early traumatic events to schizophrenia in some patients: A traumagenic neurodevelopmental model. Psychiatry, 64(4), 319–345. PubMed
Read, J., van Os, J., Morrison, A. P., & Ross, C. A. (2005). Childhood trauma, psychosis and schizophrenia: A literature review with theoretical and clinical implications. Acta Psychiatirica Scandinavica, 112(5), 330–350. CrossRef
Ross, C. A., Anderson, G., & Clark, P. (1994). Childhood abuse and positive symptoms of schizophrenia. Hospital & Community Psychiatry, 45, 489–491.
Schwartz, H. L. (2000). Dialogues with forgotten voices: Relational perspectives on child abuse trauma and treatment of dissociative disorders. New York: Basic Books.
Spauwen, J., Krabbendam, L., Lieb, R., Wittchen, H., & van Os, J. (2005). Impact of psychological trauma on the development of psychotic symptoms: Relationship with psychosis. British Journal of Psychiatry, 188, 527–533. CrossRef
Spitzer, R., Williams, J., Gibbon, M., & First, M. (1994). Structured Clinical Interview for DSM IV. New York: Biometrics Research.
Spitzer, C., Vogel, M., Barnow, S., Freyberger, H. J., & Grabe, H. J. (2007). Psychopathology and alexithymia in severe mental illness: The impact of trauma and posttraumatic stress symptoms. European Archive of Psychiatry and Clinical Neuroscience, 257(4), 191–196. CrossRef
Tracey, T. J., & Kokotovic, A. M. (1989). Factor Structure of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223–233. CrossRef
Ullman, S. E., & Filipas, H. H. (2001). Correlates of formal and informal support seeking in sexual assault victims. Journal of Interpersonal Violence, 16(10), 1028–1047. CrossRef
- Therapeutic Alliance in Cognitive Behavior Therapy for Schizophrenia: Association with History of Sexual Assault
Paul H. Lysaker
Samantha D. Outcalt
- Springer US