2010 FINE: Socialization to the Model: The Active Component in the Therapeutic Alliance? A Prelimina

[Esther12]

Not important, but I don't think it's been mentioned here before. It would be interesting to do a study seeing what percentage of FINE papers actually make it clear that the study did not get a positive result for their treatment.

Full thing is only a page, but here's the abstract:

Authors: Daniels J, Wearden AJ.
Publication: Behavioural and Cognitive Psychotherapy

Publication Date: 22nd November 2010

University of Bath, UK.

Background

Therapeutic alliance has been found to be a significant predictor of outcome in psychotherapy yet what constitutes therapeutic alliance remains unclear. Examining the common constructs of therapeutic alliance, it is possible that there may be a conceptual overlap between active components of therapeutic alliance and socialization to the treatment model.

Aim

To investigate the relationship between socialization to the model and therapeutic alliance.

Method

Participants (N = 43) were taken from the active treatment arm in a RCT for the treatment of chronic fatigue syndrome (CFS/ME). Therapeutic alliance was measured using a 5-item questionnaire (brief CALPAS) and socialization to the model was extracted from therapy tapes using a novel coding system.

Results

Key findings were that when patients and therapists agreed about goals of treatment, there were higher levels of concordance, less evidence of applying principles incongruent to the model, and less resistance during the treatment sessions.

Conclusions

The outcome of this preliminary study contributes to the potential understanding of active components in the therapeutic alliance, and supports further research to achieve a more detailed picture of "non-specific" factors in therapy, including the active process of socialization in therapeutic alliance.

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.363.4159&rep=rep1&type=pdf

I feel like they've left out the data I'd be interested in.

This doesn't seem that amazing a find:

Key findings were that when patients and therapists agreed about goals of treatment, there were higher levels of concordance, less evidence of applying principles incongruent to the model, and less resistance during the treatment sessions.

From the paper:

Correlations were moderate in strength and in the expected directions. More specifically, analysis indicated that the more agreement expressed by
the participant in terms of the treatment goals, the more they demonstrated concordance with the therapist in session, the less avoidance and
resistance was shown, and the more they made changes to ameliorate their symptoms in a way that was consistent with the model. This suggests
that agreement about goals of treatment between therapist and participant are important to the process of therapy. If the therapist and participants
have different ideas and a lack of agreement about goals, then it is logical that participants may not follow the rationale, and subsequently show
resistance, avoidance and make changes that are inconsistent with the rationale of the therapy.

They don't dwell on the fact that FINE was a null result, do they? Also, they don't say whether making more changes to ameliorate symptoms in a way that is consistent with the model actually led to improvements in self-reported symptoms. Which would seem to be important.

My assumption would be that patients who got on with therapists and agreed with their model of illness would be more likely to report improvements in symptoms, regardless of whether the treatment was effective. Maybe not here though?

 

[Dolphin]

Not important, but I don't think it's been mentioned here before. It would be interesting to do a study seeing what percentage of FINE papers actually make it clear that the study did not get a positive result for their treatment.

Would be good.

Interesting points you raise in terms of what reported.

 

[Dolphin]

New David Tuller article today:
"Trial By Error, Continued: Why has the PACE Study’s “Sister Trial” been “Disappeared” and Forgotten?"

http://www.virology.ws/2015/11/09/t...-sister-trial-been-disappeared-and-forgotten/

Phoenix Rising thread on it:
http://forums.phoenixrising.me/inde...rial”-been-“disappeared”-and-forgotten.41104/