Psychological treatment dropout among pathological gamblers

2007 ◽  
Vol 27 (8) ◽  
pp. 944-958 ◽  
Author(s):  
Katherine M. Melville ◽  
Leanne M. Casey ◽  
David J. Kavanagh
Keyword(s):  
Psychological Treatment ◽  
Treatment Dropout ◽  
Pathological Gamblers

scholarly journals Development of the therapeutic alliance and its association with treatment outcome in internet-based Mindfulness-Based Cognitive Therapy (eMBCT) compared to group-based MBCT (MBCT) for distressed cancer patients (Preprint)

2019 ◽  
Author(s):  
Else Bisseling ◽  
Linda Cillessen ◽  
Philip Spinhoven ◽  
Melanie Schellekens ◽  
Félix Compen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Psychological Distress ◽  
Therapeutic Alliance ◽  
Cognitive Therapy ◽  
Cancer Patients ◽  
Psychological Treatment ◽  
Well Being ◽  
Post Treatment ◽  
Treatment Dropout ◽  
Mental Well Being

BACKGROUND Mindfulness-Based Cognitive Therapy (MBCT) is an evidence-based group-based psychological treatment in oncology, resulting in reduction of depressive and anxiety symptoms. Internet-based Mindfulness-based Cognitive Therapy (eMBCT) has been found to be an effective alternative for MBCT. The therapeutic alliance, i.e. the bond between therapist and patient, is known to have a significant impact on psychological treatment outcomes, including MBCT. A primary concern in the practice of eMBCT is whether a good therapeutic alliance can develop. Although evidence for the beneficial effect of therapist-assistance on treatment outcome in internet-based interventions (IBIs) is accumulating, it is still unclear whether the therapeutic alliance is related to outcome in IBIs. OBJECTIVE The objectives of the present study were: (1) to explore whether early therapeutic alliance predicts treatment dropout in (e)MBCT; (2) to compare the development of the therapeutic alliance during eMBCT and MBCT; and (3) to examine whether early therapeutic alliance is a predictor of the reduction of psychological distress and the increase of mental well-being at post-treatment in both conditions. METHODS The present study was part of a multicentre randomized controlled trial (RCT; n=245) on the effectiveness of (e)MBCT for distressed cancer patients. The therapeutic alliance was measured at the start of week 2 (i.e. early therapeutic alliance), week 5 and week 9. Outcome measures were psychological distress, measured with the Hospital Anxiety and Depression Scale (HADS) and mental-wellbeing, measured with the Mental Health Coninuum-short form (MHC-SF). RESULTS The strength of early therapeutic alliance did not predict treatment dropout in (e)MBCT (B=-0.39, p=.21). Therapeutic alliance increased over time in both conditions (F=16.46,Wilks’ λ=.732, p<.001). This increase did not differ between eMBCT and MBCT (F=0.114, p=.74). Therapeutic alliance at week 2 predicted a reduction of psychological distress (B=-.126, t=-2.656, p=.01) and an increase of in mental well-being (B=.234, t=2.651, p=.01) at post-treatment. The relationship with reduction of psychological distress differed between treatments: a weaker early therapeutic alliance predicted higher psychological distress at post-treatment in MBCT but not in eMBCT(B=.217, t=2.261, p=.03). CONCLUSIONS A therapeutic alliance can develop in both eMBCT and MBCT. Findings revealed that the strength of early alliance did not predict treatment dropout. Furthermore, the level of therapeutic alliance predicted reduced psychological distress and increased mental well-being at post-treatment in both conditions. Interestingly, the strength of therapeutic alliance is appeared to be more related to treatment outcome in group-based MBCT than in eMBCT. CLINICALTRIAL NCT02138513 https://clinicaltrials.gov/ct2/show/NCT02138513

scholarly journals Development of the Therapeutic Alliance and its Association With Internet-Based Mindfulness-Based Cognitive Therapy for Distressed Cancer Patients: Secondary Analysis of a Multicenter Randomized Controlled Trial

10.2196/14065 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14065 ◽  
Author(s):  
Else Bisseling ◽  
Linda Cillessen ◽  
Philip Spinhoven ◽  
Melanie Schellekens ◽  
Félix Compen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Psychological Distress ◽  
Therapeutic Alliance ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Well Being ◽  
Treatment Dropout ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
Mental Well Being

Background Mindfulness-based cognitive therapy (MBCT) is an evidence-based group-based psychological treatment in oncology, resulting in reduction of depressive and anxiety symptoms. Internet-based MBCT (eMBCT) has been found to be an effective alternative for MBCT. The therapeutic alliance (the bond between therapist and patient,) is known to have a significant impact on psychological treatment outcomes, including MBCT. A primary concern in the practice of eMBCT is whether a good therapeutic alliance can develop. Although evidence for the beneficial effect of therapist assistance on treatment outcome in internet-based interventions (IBIs) is accumulating, it is still unclear whether the therapeutic alliance is related to outcome in IBIs. Objective This study aimed to (1) explore whether early therapeutic alliance predicts treatment dropout in MBCT or eMBCT, (2) compare the development of the therapeutic alliance during eMBCT and MBCT, and (3) examine whether early therapeutic alliance is a predictor of the reduction of psychological distress and the increase of mental well-being at posttreatment in both conditions. Methods This study was part of a multicenter randomized controlled trial (n=245) on the effectiveness of MBCT or eMBCT for distressed cancer patients. The therapeutic alliance was measured at the start of week 2 (ie, early therapeutic alliance), week 5, and week 9. Outcome measures were psychological distress, measured with the Hospital Anxiety and Depression Scale, and mental well-being, measured with the Mental Health Continuum-Short Form. Results The strength of early therapeutic alliance did not predict treatment dropout in MBCT or eMBCT (B=−.39; P=.21). Therapeutic alliance increased over time in both conditions (F2,90=16.46; Wilks λ=0.732; P<.001). This increase did not differ between eMBCT and MBCT (F1,91=0.114; P=.74). Therapeutic alliance at week 2 predicted a decrease in psychological distress (B=−.12; t114=−2.656; P=.01) and an increase in mental well-being (B=.23; t113=2.651; P=.01) at posttreatment. The relationship with reduction of psychological distress differed between treatments: a weaker early therapeutic alliance predicted higher psychological distress at posttreatment in MBCT but not in eMBCT (B=.22; t113=2.261; P=.03). Conclusions A therapeutic alliance can develop in both eMBCT and MBCT. Findings revealed that the strength of early alliance did not predict treatment dropout. Furthermore, the level of therapeutic alliance predicted reduced psychological distress and increased mental well-being at posttreatment in both conditions. Interestingly, the strength of therapeutic alliance appeared to be more related to treatment outcome in group-based MBCT than in eMBCT. Trial Registration ClinicalTrials.gov NCT02138513; https://clinicaltrials.gov/ct2/show/NCT02138513

Chronic Pain: Fundamental Scientific Considerations, Specifically for Legal Claims

2013 ◽  
Vol 18 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Robert J. Barth
Keyword(s):  
Health Outcomes ◽  
Pain Perception ◽  
Driving Forces ◽  
Psychological Treatment ◽  
Dominant Role ◽  
Meta Analysis ◽  
General Medicine ◽  
Pain Syndrome ◽  
Problematic Relationship

Abstract Scientific findings have indicated that psychological and social factors are the driving forces behind most chronic benign pain presentations, especially in a claim context, and are relevant to at least three of the AMA Guides publications: AMA Guides to Evaluation of Disease and Injury Causation, AMA Guides to Work Ability and Return to Work, and AMA Guides to the Evaluation of Permanent Impairment. The author reviews and summarizes studies that have identified the dominant role of financial, psychological, and other non–general medicine factors in patients who report low back pain. For example, one meta-analysis found that compensation results in an increase in pain perception and a reduction in the ability to benefit from medical and psychological treatment. Other studies have found a correlation between the level of compensation and health outcomes (greater compensation is associated with worse outcomes), and legal systems that discourage compensation for pain produce better health outcomes. One study found that, among persons with carpal tunnel syndrome, claimants had worse outcomes than nonclaimants despite receiving more treatment; another examined the problematic relationship between complex regional pain syndrome (CRPS) and compensation and found that cases of CRPS are dominated by legal claims, a disparity that highlights the dominant role of compensation. Workers’ compensation claimants are almost never evaluated for personality disorders or mental illness. The article concludes with recommendations that evaluators can consider in individual cases.

Are Individuals in Rorschach Nonpatient Samples Truly Psychologically Healthy?

2015 ◽  
Vol 36 (2) ◽  
pp. 112-155 ◽  
Author(s):  
Anna Maria Rosso ◽  
Andrea Camoirano ◽  
Gabriele Schiaffino
Keyword(s):  
Psychological Treatment ◽  
Coping Styles ◽  
Anxiety And Depression ◽  
Future Research ◽  
Extensive Form ◽  
Community Needs ◽  
Rorschach Comprehensive System ◽  
Form Quality ◽  
And Coping ◽  
Rorschach Variables

Abstract. The aim of this study was to collect a Rorschach Comprehensive System (RCS) adult nonpatient sample from Italy using more stringent exclusion criteria and controlling for psychopathology, taking into account the methodological suggestions of Ritzler and Sciara (2008) . The authors hypothesized that: (a) adult nonpatient samples are not truly psychologically healthy, in that a high number of psychopathological symptoms are experienced by participants, particularly anxiety and depression, although they have never been in psychological treatment; (b) significant differences emerge between healthy and nonhealthy groups on Rorschach variables, particularly on CS psychopathological indexes; (c) RCS psychopathological indexes are significantly correlated in the expected direction with scores on psychopathological scales. The results confirmed the hypotheses, indicating the need to collect psychologically healthy samples in addition to normative and nonpatient samples. Because differences were found in the comparison between Exner’s sample (2007) and the healthy group in this study regarding form quality and coping styles, the authors suggest that future research should investigate the construct validity of ambitent style and culturally specific influences on form quality. Moreover, the Rorschach scientific community needs to have more extensive form quality tables, enriched with objects that are currently not included.

The Formulated Psychological Treatment of Medical Disorders

1992 ◽  
Vol 37 (12) ◽  
pp. 1286-1287
Author(s):  
Ronald A. Kleinknecht
Keyword(s):  
Psychological Treatment ◽  
Medical Disorders
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