Therapeutic Alliance Tensions and Repair in Psychotherapy Practices

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

81 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-01

Study Completion Date

2021-08-14

Brief Summary

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This study evaluates a professional development program intended to improve the relationship or alliance between therapists and patients/clients who are receiving psychotherapy in the community. Half of the participating therapists will receive training to detect and improve alliance with new patients while half will not. The professional development training is expected to improve therapists effectiveness in identifying and correcting alliance tensions which will, in turn, improve therapeutic outcomes for patients/clients.

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Detailed Description

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Psychotherapy is the treatment of choice for many mental disorders, yet there is a gap between research and practice. Research indicates that: the therapist-patient alliance is important to reduce patient symptoms, alliance tensions are detrimental to patients, and those therapists who identify and repair alliance tensions can improve patient outcomes. In this study we will use state of the art research to train community-based therapists in evidence-based interventions to identify and repair alliance tensions. Trained therapists and their patients will be compared to therapists who provide usual care to their patients. Improvement in therapists' skills in identifying and repairing alliance tensions and how this is associated with better patient mental health outcomes will be measured. Trained therapists will be interviewed to identify the best ways of improving the training and disseminating the findings to psychotherapists across Canada. Research to improve practicing therapists' ability to identify and repair therapeutic alliance tensions will result in better mental health outcomes for patients.

Conditions

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Psychotherapy Therapeutic Alliance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This will be a 2-arm, parallel, prospective, single-blind cluster RCT with 1-1 allocation comparing: (a) therapists who receive the professional development intervention to identify and repair alliance tensions at the study outset versus (b) therapists who receive the intervention after participation is complete (no training control). Therapists will be randomized to study condition and patients will be clustered within therapists. Randomization will control for: (a) the effect of therapist variables (age, gender, theoretical orientation, experience, differing initial skill level) on competence, therapeutic alliance, or patient outcomes; (b) potential biases caused by pre-treatment patient variables (symptom severity, co-morbidity, chronicity, psychoactive medications); and (c) treatment or study factors (e.g. frequency of sessions, time to complete the study sessions, treatment received after the study sessions). Patients will be blind to therapist study arm allocation.

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Participating therapists will be aware of their group (Professional development training vs no training control); however, their participating patient/clients will not know which experimental group their therapists belongs to.

Study Groups

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Professional Development Program

Therapists who participate in workshops and consultation sessions with study trainers during study-related therapy sessions and their participating patients/clients.

Group Type EXPERIMENTAL

Professional development program

Intervention Type OTHER

Professional development program consists of training including workshops and consultation sessions to enhance therapists ability to detect and repair alliance ruptures in active community based psychotherapy.

Control

Therapists who did not participate in workshops and consultations sessions while engaging in study-related therapy sessions and their participating patients/clients.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Professional development program

Professional development program consists of training including workshops and consultation sessions to enhance therapists ability to detect and repair alliance ruptures in active community based psychotherapy.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* regulated health professional
* in good standing with a Canadian provincial regulatory college
* scope of practice includes psychotherapy
* ability to add 3 or more new, English speaking clients to caseload over 6 to 9 months
* ability to obtain timely permission to conduct research from therapist's employing institution or health group when applicable

* 18 years of age or older
* will participate in psychotherapy sessions in English
* will see the study-affiliated therapist for a minimum of 6 sessions in the next 6 months

Exclusion Criteria

* none

Patient/Client

* already seeing another therapist
* diagnosed with a neurocognitive disorder
* diagnosed with a psychotic disorder
* expressed suicidal behaviour in the past six months as assessed by their participating therapist

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes