Therapeutic Alliance Tensions and Repair in Psychotherapy Practices

Psychotherapy Clinical Trial

Official title:

Therapeutic Alliance Tensions and Repair in Psychotherapy Practices: A Psychotherapy Practice Research Network (PPRNet) Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03453957
• Other study ID #: 363733
• Status: Completed
• Phase: N/A
• Start date: February 1, 2018
• Est. completion date: August 14, 2021

Study information

• Verified date: June 2022
• Source: University of Ottawa
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates a professional development program intended to improve the relationship or alliance between therapists and patients/clients who are receiving psychotherapy in the community. Half of the participating therapists will receive training to detect and improve alliance with new patients while half will not. The professional development training is expected to improve therapists effectiveness in identifying and correcting alliance tensions which will, in turn, improve therapeutic outcomes for patients/clients.

Description:

Psychotherapy is the treatment of choice for many mental disorders, yet there is a gap between research and practice. Research indicates that: the therapist-patient alliance is important to reduce patient symptoms, alliance tensions are detrimental to patients, and those therapists who identify and repair alliance tensions can improve patient outcomes. In this study we will use state of the art research to train community-based therapists in evidence-based interventions to identify and repair alliance tensions. Trained therapists and their patients will be compared to therapists who provide usual care to their patients. Improvement in therapists' skills in identifying and repairing alliance tensions and how this is associated with better patient mental health outcomes will be measured. Trained therapists will be interviewed to identify the best ways of improving the training and disseminating the findings to psychotherapists across Canada. Research to improve practicing therapists' ability to identify and repair therapeutic alliance tensions will result in better mental health outcomes for patients.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 81
• Est. completion date: August 14, 2021
• Est. primary completion date: May 14, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Therapist

Inclusion Criteria:

• regulated health professional

• in good standing with a Canadian provincial regulatory college

• scope of practice includes psychotherapy

• ability to add 3 or more new, English speaking clients to caseload over 6 to 9 months

• ability to obtain timely permission to conduct research from therapist's employing institution or health group when applicable

Exclusion Criteria:

• none

Patient/Client

Inclusion Criteria:

• 18 years of age or older

• will participate in psychotherapy sessions in English

• will see the study-affiliated therapist for a minimum of 6 sessions in the next 6 months

Exclusion Criteria:

• already seeing another therapist

• diagnosed with a neurocognitive disorder

• diagnosed with a psychotic disorder

• expressed suicidal behaviour in the past six months as assessed by their participating therapist

Related Conditions & MeSH terms

• Psychotherapy
• Therapeutic Alliance

Intervention

Other:
• Professional development program
Professional development program consists of training including workshops and consultation sessions to enhance therapists ability to detect and repair alliance ruptures in active community based psychotherapy.

Locations

Country	Name	City	State
Canada	University of Ottawa	Ottawa	Ontario
Canada	Mt. Sinai Hospital	Toronto	Ontario

Sponsors (2)

Lead Sponsor	Collaborator
University of Ottawa	Canadian Institutes of Health Research (CIHR)

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Mean tension resolution rating scale	The Rupture Resolution Rating System (3RS) is an observer-based measure to identify alliance tensions and resolution processes. Independent blind reliable trained judges will rate video recordings of 6 psychotherapy session recorded with participating clients. A mean tension score will be assigned per client which will be the average of the 6 session scores.; score ranges from 1 (withdrawal/confrontation rupture(s) did not occur; not significant for the alliance) to 5 (withdrawal/confrontation rupture(s) occurred; significant for the alliance).	6 therapy sessions over 6 weeks up to 6 months depending on the frequency of therapy
Secondary	Generalized Anxiety Disorder 7-item scale (GAD-7) change from baseline	Self-report measurement of severity of anxiety using the GAD-7 scale. A change in anxiety scores will be assess following 6 therapy session with data collected before therapy(baseline) and again after all 6 sessions of therapy have been completed. Scores range from 0 (low anxiety) to 27 (high anxiety) with scores over 10 being of clinical significance.	baseline and end of 6 therapy sessions, 6 weeks to 6 months depending on the frequency of therapy
Secondary	Patient Health Questionnaire 9-item scale (PHQ-9) change from baseline	Self-report measurement of depression symptoms using the PHQ-9 scale. A change in depression symptom scores will be assess following 6 therapy session with data collected before therapy and again after all 6 sessions of therapy have been completed. Scores range from 0 (low) to 27 (high) with scores over 10 being of clinical significance.	baseline and end of 6 therapy sessions, 6 weeks to 6 months depending on the frequency of therapy

External Links

•   PPRNet website including study-related information and publications