Therapeutic Alliance Tensions and Repair in Psychotherapy Practices

University of Ottawa

Status: Completed

Conditions: Psychotherapy; Therapeutic Alliance

Treatments: Other: Professional development program

Study type: Interventional

Funder types: Other

Identifiers

NCT03453957

363733

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 81 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Therapist

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

Exclusion Criteria:

• none

Patient/Client

Inclusion Criteria:

• 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:

• 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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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81 participants in 2 patient groups

Professional Development Program

Experimental group

Description:

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

Treatment:

Other: Professional development program

Control

No Intervention group

Description:

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