학술논문

Therapeutic alliance and treatment outcome in psychodynamic psychotherapy of depressed breast cancer patients: the same old story or different from other populations?
Document Type
Academic Journal
Source
Breast Cancer. November 2017, Vol. 24 Issue 6, p765, 9 p.
Subject
Medical research -- Analysis
Medicine, Experimental -- Analysis
Cancer patients -- Care and treatment -- Patient outcomes
Depression, Mental -- Care and treatment -- Patient outcomes
Psychotherapy -- Analysis
Breast cancer -- Care and treatment -- Patient outcomes
Health
Alliances and partnerships
Diseases
Care and treatment
Analysis
Patient outcomes
Language
English
ISSN
1340-6868
Abstract
Background A good therapeutic alliance is associated with better treatment outcomes in diverse types of psychotherapy and patient populations, but little is known about therapeutic alliance in psychotherapies with cancer patients. This study examines the association of therapeutic alliance and treatment outcome in short term psychodynamic psychotherapy (STPP) for breast cancer patients. Methods Within a randomized controlled trial, 47 completers of STPP could be included in the analyses. The therapeutic alliance was assessed by patients and therapists at treatment termination with the Helping Alliance Questionnaire. Outcome was defined as no diagnosis of depression assessed with Structured Clinical Interview for DSM-IV (SCID-I) and a reduction of the HADS-depression score by at least two points at treatment termination. Results Patients' alliance ratings were significantly associated with outcome (r = 0.46, p = 0.015), while, in contrast to findings in non-cancer populations, therapists' ratings were unrelated. There was no association between patients' and therapists' ratings of therapeutic alliance. Especially success and working related aspects of patients' alliance scores were associated with outcome. Patients' and therapists' alliance scores were unrelated to any of their baseline characteristics, therapist characteristic or treatment variables. Conclusion We conclude that therapists should regularly assess the quality of patients' perceived therapeutic alliance in the course of psychotherapy with breast cancer patients to improve psychotherapy outcome. The breast cancer patients' perspective should be actively inquired and considered throughout treatment by therapists. Possible discrepancies between both judgements can be addressed in treatment.
Author(s): Katja Leuteritz [sup.1], Gregor Weißflog [sup.1], Yvette Barthel [sup.3], Elmar Brähler [sup.1] [sup.2], Rüdiger Zwerenz [sup.2], Jörg Wiltink [sup.2], Manfred E. Beutel [sup.2] Author Affiliations: (1) 0000 0001 2230 [...]