Publication Type Academic Article
Authors Solomonov N, Falkenström F, Gorman B, McCarthy K, Milrod B, Rudden M, Chambless D, Barber J
Journal Psychother Res
Volume 30
Issue 1
Pagination 97-111
Date Published 03/01/2019
ISSN 1468-4381
Keywords Cognitive Behavioral Therapy, Interpersonal Relations, Outcome Assessment, Health Care, Panic Disorder, Psychotherapy, Psychodynamic, Sensation, Therapeutic Alliance
Abstract ABSTRACTObjective: To examine whether working alliance quality and use of techniques predict improvement in Panic-Specific Reflection Function (PSRF), and misinterpretation of bodily sensations in treatments for panic disorder. Method: A sample of 161 patients received either CBT or PFPP (Panic-focused Psychodynamic therapy) within a larger RCT. Data were collected on patient-reported working alliance, misinterpretations, PSRF, observer-coded use of techniques, and interviewer-rated panic severity. Random-Intercept Cross-Lagged Panel Models assessed bi-directional associations, disentangling within- and between-patient effects, and accounting for prior change. Results: Higher alliance predicted subsequent within-patient improvement in PSRF in PFPP, but worsening in CBT. In both treatments, focus on interpersonal relationships predicted PRSF improvement (with stronger effects in CBT), while focus on thoughts and behaviors predicted worsening in PSRF. In CBT only, early focus on affect and moment-to-moment experience predicted reduced misinterpretation, while high focus on thoughts and cognitions predicted subsequent increase in misinterpretation. Conclusion: The quality of the alliance has differential effects on PSRF in distinct treatments. Interpersonal, rather than cognitive or behavioral focus, even when delivered differently within distinct treatments with high adherence, could facilitate improvement in PSRF. Additionally, early focus on affect and moment-to-moment experiences in CBT could reduce misinterpretations.
DOI 10.1080/10503307.2019.1585591
PubMed ID 30821630
PubMed Central ID PMC6778028
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