Therapeutic alliance in Enhanced Cognitive Behavioural Therapy for bulimia nervosa: Probably necessary but definitely insufficient
MetadataShow full item record
The present paper assessed therapeutic alliance over the course of Enhanced Cognitive Behavioural Therapy (CBT-E) in a community-based sample of 112 patients with a diagnosis of bulimia nervosa (BN) or atypical BN. Temporal assessment of alliance was conducted at three time points (the start, middle and end of treatment) and the relationship between alliance and treatment retention and outcome was explored. Results indicated that the alliance between patient and therapist was strong at all stages of CBT-E, and even improved in the early stages of treatment when behaviour change was initiated (weekly in-session weighing, establishing regular eating, and ceasing binge-eating and compensatory behaviours).The present study found no evidence that alliance was related to treatment retention or outcomes, or that symptom severity or problematic interpersonal styles interacted with alliance to influence outcomes. Alliance was also unrelated to baseline emotional or interpersonal difficulties. The study provides no evidence that alliance has clinical utility for the prediction of treatment retention or outcome in CBT-Efor BN, even for individuals with severe symptoms or problematic interpersonal styles. Early symptom change was the best predictor of outcome in CBT-E. Further research is needed to determine whether these results are generalizable to patients with anorexia nervosa.
NOTICE: this is the author’s version of a work that was accepted for publication in Behaviour Research and Therapy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Behaviour Research and Therapy, Vol. 57 (2014). DOI: 10.1016/j.brat.2014.04.004
Showing items related by title, author, creator and subject.
The relationship between interpersonal problems, therapeutic alliance, and outcomes following group and individual cognitive behaviour therapyMcEvoy, Peter; Burgess, M.; Nathan, P. (2014)Background: Cognitive behavioural therapy (CBT) is efficacious, but there remains individual variability in outcomes. Patient's interpersonal problems may affect treatment outcomes, either directly or through a relationship ...
The impact of therapy process on outcomes for families of children with disabilities and behaviour problems attending group parent trainingWalsh, Nicole K (2008)Despite the positive effects found for both parents and children following different parent training interventions, a significant proportion of families fail to experience successful outcomes (Assemany & McIntosh, 2002). ...
Tasca, G.; Lampard, Amy (2012)The nature of the alliance–outcome relationship is still emerging. This study examined the reciprocal influence of change in alliance to the group and change in urge to restrict in eating-disordered individuals attending ...