Therapeutic Alliance Is Calming and Curing - The Interplay Between Alliance and Emotion Regulation as Predictors of Outcome in Internet-Based Treatments for Adolescent DepressionShow others and affiliations
2023 (English)In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 91, no 7, p. 426-437Article in journal (Refereed) Published
Abstract [en]
Objective: Therapeutic alliance is one of the most stable predictors of outcome in psychotherapy, regardless of theoretical orientation. The alliance-outcome relationship in internet-based treatments has been investigated with mixed results. There is preliminary evidence that emotion regulation can work as a mediator for the alliance-outcome relationship. The present study aimed to investigate whether alliance predicted outcome session by session in two internet-based treatments for adolescent depression, and whether this relationship was mediated by emotion regulation. Method: Two hundred and seventy-two participants aged 15-19 years and diagnosed with depression were randomized to 10 weeks of internet-based psychodynamic or cognitive behavioral treatment. Both therapists and patients rated the alliance weekly. Patients also rated depressive symptoms and emotion regulation weekly. Analyses were made using cross-lagged panel modeling. Results: Alliance, as rated by both therapist and patient, predicted depression scores the following week. Emotion regulation rated by the patient also predicted depression scores the following week. Furthermore, alliance scores predicted emotion regulation scores the following week, which in turn predicted depression scores the week after, supporting the hypothesis that alliance influences outcome partly through emotion regulation. There were no group differences in any of these relationships. Conclusion: Alliance seems to play an important role in internet-based treatments, partly through emotion regulation. Clinicians working with text-based treatments should pay attention to the working alliance.
Place, publisher, year, edition, pages
American Psychological Association (APA), 2023. Vol. 91, no 7, p. 426-437
Keywords [en]
alliance, adolescents, internet-based PDT, internet-based CBT, psychotherapy process
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
URN: urn:nbn:se:lnu:diva-121488DOI: 10.1037/ccp0000815ISI: 000985641300001PubMedID: 37166833Scopus ID: 2-s2.0-85163922992OAI: oai:DiVA.org:lnu-121488DiVA, id: diva2:1764353
2023-06-082023-06-082023-08-25Bibliographically approved