Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - An exploration of the therapeutic alliance within a telephone-based cognitive behaviour therapy for individuals with experience of psychosis
AU - Mulligan, John
AU - Haddock, Gillian
AU - Hartley, Samantha
AU - Davies, J
AU - Sharp, T
AU - Kelly, James
AU - Neil, Sandra
AU - Taylor, Chris
AU - Welford, Mary
AU - Price, Jason
AU - Rivers, Zoe
AU - Barrowclough, Christine
PY - 2014
Y1 - 2014
N2 - ObjectivesThis study investigated the therapeutic alliance (TA) between clients and therapists involved in a telephone‐based cognitive behaviour therapy (CBT) oriented psychological intervention for individuals experiencing psychosis.DesignThe telephone intervention involved recovery‐focused CBT with use of a self‐help guide and group intervention co‐facilitated by colleagues with personal experience of psychosis. It was delivered as part of a Participant Preference Trial.MethodsTwenty‐one client/therapist dyads were examined within this study. In addition to a measure of TA, clients completed measures of depression, social functioning, symptom severity, and strength of treatment preference, while therapists completed measures related to the level of shared formulation, therapist confidence, and therapeutic change estimates.ResultsTherapeutic alliance levels were comparable to previously reported face‐to‐face psychosis intervention studies. Clients consistently reported significantly higher TA ratings compared to therapists. Depression scores and the strength of preference for treatment were significantly associated with client TA. Greater therapist perceived change was associated with higher therapist rated TA, while higher numbers of missed therapy sessions associated with lower therapist ratings.ConclusionsTelephone‐based psychosis interventions may support the formation of positive relationships that are comparable to the quality of relationships developed between therapists and clients during face‐to‐face CBT therapy. Methodological limitations including low participant numbers and heightened risk of a Type I error necessitate caution when interpreting findings. Further research into therapist and client variables associated with TA is required.Practitioner pointsTelephone delivered interventions to support people with psychosis‐related difficulties can result in the development of a good quality TA between therapists and clients.There is a significant difference between therapist and client ratings of TA. Clients tend to score the quality of the TA significantly more highly than therapists.Providing clients with choice when participating in therapeutic interventions could potentially contribute towards improved TA reporting by clients.
AB - ObjectivesThis study investigated the therapeutic alliance (TA) between clients and therapists involved in a telephone‐based cognitive behaviour therapy (CBT) oriented psychological intervention for individuals experiencing psychosis.DesignThe telephone intervention involved recovery‐focused CBT with use of a self‐help guide and group intervention co‐facilitated by colleagues with personal experience of psychosis. It was delivered as part of a Participant Preference Trial.MethodsTwenty‐one client/therapist dyads were examined within this study. In addition to a measure of TA, clients completed measures of depression, social functioning, symptom severity, and strength of treatment preference, while therapists completed measures related to the level of shared formulation, therapist confidence, and therapeutic change estimates.ResultsTherapeutic alliance levels were comparable to previously reported face‐to‐face psychosis intervention studies. Clients consistently reported significantly higher TA ratings compared to therapists. Depression scores and the strength of preference for treatment were significantly associated with client TA. Greater therapist perceived change was associated with higher therapist rated TA, while higher numbers of missed therapy sessions associated with lower therapist ratings.ConclusionsTelephone‐based psychosis interventions may support the formation of positive relationships that are comparable to the quality of relationships developed between therapists and clients during face‐to‐face CBT therapy. Methodological limitations including low participant numbers and heightened risk of a Type I error necessitate caution when interpreting findings. Further research into therapist and client variables associated with TA is required.Practitioner pointsTelephone delivered interventions to support people with psychosis‐related difficulties can result in the development of a good quality TA between therapists and clients.There is a significant difference between therapist and client ratings of TA. Clients tend to score the quality of the TA significantly more highly than therapists.Providing clients with choice when participating in therapeutic interventions could potentially contribute towards improved TA reporting by clients.
U2 - 10.1111/papt.12018
DO - 10.1111/papt.12018
M3 - Journal article
VL - 87
SP - 393
EP - 410
JO - Psychology and Psychotherapy: Theory, Research and Practice
JF - Psychology and Psychotherapy: Theory, Research and Practice
SN - 1476-0835
IS - 4
ER -