TAKE ME BACK TO MOVE ME FORWARD: RE-ENACTMENT OF THE FAMILY SYSTEM AS A PATHWAY TO BETTER QUALITY OF LIFE FOR ALEXITHYMIC PATIENTS IN GROUP THERAPY

Background: Despite much attention in the clinical literature, research on alexithymia in the treatment setting has only recently gained traction. While several reports indicate limited benefit from therapy amongst patients with high alexithymia, this seems to be less so in the context of group therapy. This study considers a specific aspect of the group therapy process - family re-enactment - in facilitating improvement in overall quality of life for patients with high levels of alexithymia. Subjects and methods: Family re-enactment was examined as a potential mediator of the relationship between alexithymia and change in quality of life among 50 patients who completed treatment in an intensive, integrative group therapy programme. Patients completed three self-report measures: Toronto Alexithymia Scale-20 (baseline), Quality of Life Inventory (baseline, post-therapy), and Therapeutic Factors Inventory-Short Form (week 8). Regression with mediation analysis was employed using the change score for the QOLI as the dependent variable, alexithymia scores as the independent variable, and the family re-enactment score as the mediator; baseline quality of life was included in the model as a control variable. Results: Family re-enactment emerged as a significant mediator of the relationship between alexithymia and treatment outcome, implicating it as a contributing mechanism of change for alexithymic patients who participate in group therapy. Conclusion: Patients with higher levels of alexithymia (in particular, difficulty identifying and describing feelings) were more likely to positively endorse aspects of family re-enactment during group therapy, which in turn were significantly associated with greater improvement in patients’ overall quality of life

The relation between outcome expectation, therapeutic alliance, and outcome among depressed patients in group cognitive-behavioral therapy

OBJECTIVE: Although patients' expectation for improvement correlates with their treatment outcome, there remains limited information regarding the mechanisms through which outcome expectation influences outcome. Although several studies have revealed alliance as a mediator of the expectancy-outcome relation, most have focused on individual psychotherapy only. More research is needed examining mediators, including alliance quality, of the outcome expectation-outcome relation in group therapy. METHOD: This study focused on such associative chains among 91 depressed outpatients who completed 10 weeks of group cognitive-behavioral therapy. We conducted simple and multiple mediation analyses, accounting for the nested data structure. RESULTS: As predicted, we found: (i) The relations between baseline outcome expectation and both posttreatment anxiety and depression were mediated by alliance quality; (ii) the early therapy outcome expectation-posttreatment anxiety relation was mediated by mid-treatment alliance; (iii) the relation between early alliance and posttreatment interpersonal problems was mediated by during-therapy outcome expectation; and (iv) the relation between baseline outcome expectation and posttreatment interpersonal problems was mediated by two variables acting in turn, early alliance and during-therapy outcome expectation. All other tested models were not significant. CONCLUSIONS: Results suggest that bidirectional relations between outcome expectation and alliance, with both directions influencing outcome. Clinical and empirical implications are discussed

Forward thinking: correlates of posttreatment outcome expectation among depressed outpatients /Pensamiento prospectivo: correlatos de las expectativas de resultados post-tratamiento de pacientes ambulatorios que sufren depresión

Although patients’ expectation about a treatment’s efficacy correlate with beneficial therapy processes and outcomes, scant research addresses patients’ expectation for lasting improvement at treatment’s end. Given the influence of beliefs on psychological functioning, posttreatment outcome expectation reflects an important acute treatment outcome. In this study, we examined patient characteristics, treatment processes and clinical change factors in relation to the posttreatment outcome expectation of 65 depressed outpatients completing group cognitive-behavioural therapy. Less than 1% of variability in posttreatment outcome expectation was due to group effects; thus, we conducted single-level regressions. Patients with less severe baseline depression, higher session 3 outcome expectation, more during-treatment hope and a greater reduction in interpersonal problems reported greater posttreatment outcome expectancy. Various patient characteristics and change factors can help clinicians forecast, and respond to, those patients who will possess stronger or weaker belief in their ability to maintain therapy gains at treatment’s end

Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder.

From PubMed via Jisc Publications RouterHistory: received 2020-08-27, accepted 2021-01-21Publication status: aheadofprintObsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards. [Abstract copyright: Copyright © 2021 Elsevier B.V. All rights reserved.