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Early in-session predictors of response to trauma-focused cognitive therapy for posttraumatic stress disorder. | LitMetric

AI Article Synopsis

  • Trauma-focused cognitive behavior therapy is effective for PTSD but has a non-response rate of 25% to 50%, prompting a study on early session behavioral predictors of treatment outcomes.
  • The research examined audio or video recordings of initial sessions for 58 patients, focusing on behaviors like perseveration and emotional expression, as well as the therapeutic alliance.
  • Findings indicate that poor responders exhibited more perseveration and less emotional expression, which correlated with a weaker therapeutic alliance and compromised treatment delivery, suggesting these patients may require different treatment strategies.

Article Abstract

Trauma-focused cognitive behaviour therapy is effective in treating posttraumatic stress disorder but non-response rates range between 25% and 50%. Results of previous research on patient characteristics predicting outcome are inconsistent and mainly focused on demographic and diagnostic variables. This study examined whether behavioural predictors of poor treatment response can be observed in early sessions. It was predicted that greater patient perseveration, lower expression of thoughts and feelings and weaker therapeutic alliance would be associated with poorer outcomes. We also explored the relationships of patient behaviours with therapeutic alliance and the efficiency and competence of treatment delivery. Audio or video recordings of the initial treatment sessions of 58 patients who had shown either good (n = 34) or poor response (n = 24) to cognitive therapy for PTSD (CT-PTSD, Ehlers & Clark, 2000) were blindly coded for patient perseveration, expression of thoughts and feelings, therapeutic alliance, efficiency and competency of treatment delivery and therapist competence. Poor responders showed more perseveration and less expression of thoughts and feelings in the initial session. Patient perseveration and low expression of thoughts and feelings were associated with poorer therapeutic alliance and compromised treatment delivery. Patients with these behavioural characteristics may benefit from additional treatment strategies. Limitations of the study and implications for clinical practice are discussed.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686047PMC
http://dx.doi.org/10.1016/j.brat.2015.10.001DOI Listing

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