Therapist Effects and the Impact of Early Therapeutic Alliance on Symptomatic Outcome in Chronic Fatigue Syndrome

Few studies have examined therapist effects and therapeutic alliance (TA) in treatments for chronic fatigue syndrome (CFS). Therapist effects are the differences in outcomes achieved by different therapists. TA is the quality of the bond and level of agreement regarding the goals and tasks of therapy. Prior research suffers the methodological problem that the allocation of therapist was not randomized, meaning therapist effects may be confounded with selection effects. We used data from a randomized controlled treatment trial of 296 people with CFS. The trial compared pragmatic rehabilitation (PR), a nurse led, home based self-help treatment, a counselling-based treatment called supportive listening (SL), with general practitioner treatment as usual. Therapist allocation was randomized. Primary outcome measures, fatigue and physical functioning were assessed blind to treatment allocation. TA was measured in the PR and SL arms. Regression models allowing for interactions were used to examine relationships between (i) therapist and therapeutic alliance, and (ii) therapist and average treatment effect (the difference in mean outcomes between different treatment conditions). We found no therapist effects. We found no relationship between TA and the average treatment effect of a therapist. One therapist formed stronger alliances when delivering PR compared to when delivering SL (effect size 0.76, SE 0.33, 95% CI 0.11 to 1.41). In these therapies for CFS, TA does not influence symptomatic outcome. The lack of significant therapist effects on outcome may result from the trial’s rigorous quality control, or random therapist allocation, eliminating selection effects. Further research is needed

Editorial Statement About JCCAP’s 2023 Special Issue on Informant Discrepancies in Youth Mental Health Assessments: Observations, Guidelines, and Future Directions Grounded in 60 Years of Research

Issue 1 of the 2011 Volume of the Journal of Clinical Child and Adolescent Psychology (JCCAP) included a Special Section about the use of multi-informant approaches to measure child and adolescent (i.e., hereafter referred to collectively as “youth”) mental health (De Los Reyes, 2011). Researchers collect reports from multiple informants or sources (e.g., parent and peer, youth and teacher) to estimate a given youth’s mental health. The 2011 JCCAP Special Section focused on the most common outcome of these approaches, namely the significant discrepancies that arise when comparing estimates from any two informant’s reports (i.e., informant discrepancies). These discrepancies appear in assessments conducted across the lifespan (Achenbach, 2020). That said, JCCAP dedicated space to understanding informant discrepancies, because they have been a focus of scholarship in youth mental health for over 60 years (e.g., Achenbach et al., 1987; De Los Reyes & Kazdin, 2005; Glennon & Weisz, 1978; Kazdin et al., 1983; Kraemer et al., 2003; Lapouse & Monk, 1958; Quay et al., 1966; Richters, 1992; Rutter et al., 1970; van der Ende et al., 2012). Thus, we have a thorough understanding of the areas of research for which they reliably appear when clinically assessing youth. For instance, intervention researchers observe informant discrepancies in estimates of intervention effects within randomized controlled trials (e.g., Casey & Berman, 1985; Weisz et al., 2017). Service providers observe informant discrepancies when working with individual clients, most notably when making decisions about treatment planning (e.g., Hawley & Weisz, 2003; Hoffman & Chu, 2015). Scholars in developmental psychopathology observe these discrepancies when seeking to understand risk and protective factors linked to youth mental health concerns (e.g., Hawker & Boulton, 2000; Hou et al., 2020; Ivanova et al., 2022). Thus, the 2011 JCCAP Special Section posed a question: Might these informant discrepancies contain data relevant to understanding youth mental health? Suppose none of the work in youth mental health is immune from these discrepancies. In that case, the answer to this question strikes at the core of what we produce―from the interventions we develop and implement, to the developmental psychopathology research that informs intervention development

The influence of media violence on youth

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83429/1/2003.Anderson_etal.InfluenceofMediaViolenceonYouth.PsychologicalScienceinthePublicInterest.pd

Open data from the third observing run of LIGO, Virgo, KAGRA, and GEO

The global network of gravitational-wave observatories now includes five detectors, namely LIGO Hanford, LIGO Livingston, Virgo, KAGRA, and GEO 600. These detectors collected data during their third observing run, O3, composed of three phases: O3a starting in 2019 April and lasting six months, O3b starting in 2019 November and lasting five months, and O3GK starting in 2020 April and lasting two weeks. In this paper we describe these data and various other science products that can be freely accessed through the Gravitational Wave Open Science Center at https://gwosc.org. The main data set, consisting of the gravitational-wave strain time series that contains the astrophysical signals, is released together with supporting data useful for their analysis and documentation, tutorials, as well as analysis software packages

Predictors of parent-professional alliance in home-based parenting support

Item does not contain fulltextA strong parent-professional alliance that increases over the course of care predicts positive outcomes of home-based parenting support. However, little is known about factors that influence the development or maintenance of the alliance in home-based parenting support, limiting professionals' ability to optimize the parent-professional alliance and thereby the quality of care. Therefore, the present study examined whether mandated versus voluntary service involvement, previous involvement in similar services, parenting stress, child psychosocial problems, and care expectations were associated with early parent-professional alliance and predicted change in alliance during home-based parenting support services. Questionnaire data from 60 parents (M age = 40.65 years, SD = 6.81, range 23-55 years) and their professionals collected early and late in care were analyzed using structural equation modeling. Results indicated that previous involvement in similar services was related to lower levels of early parent-reported alliance, whereas positive care expectations were related to stronger early parent- and professional-reported alliances. Moreover, care expectations predicted change in professional-reported alliance during care, with positive parent expectations predicting a decrease and positive professional expectations predicting an increase in alliance. Mandated versus voluntary service involvement, parenting stress and child psychosocial problems were not found to influence the alliance. These findings emphasize the need for professionals to discuss previous service involvement and care expectations as well as a need for future studies to identify other factors that influence alliance and alliance-building skills.8 p

Predictive value of parent-professional alliance for outcomes of home-based parenting support

Item does not contain fulltextBackground: Home-based parenting support within youth care services is one of the key interventions provided to families encountering difficulties with child rearing and child development. However, knowledge on factors contributing to positive outcomes of home-based parenting support is limited. Objective: The current study investigated the predictive value of (1) early parent-professional alliance and (2) change in alliance during care for outcomes of home-based parenting support. Method: Multi-informant self-report alliance and outcome data from 146 parents (Mage = 40.00, SD = 7.10; range 19-57 years) and their professionals collected early and late in care were analyzed using latent growth curve modeling. Results: Findings demonstrated that higher levels of early parent-reported alliance predicted higher levels of parent-reported satisfaction with care, and improved parent functioning. Higher levels of early professional-reported alliance predicted higher levels of parent- and professional-reported satisfaction, and improved parent functioning. Increases in professional-reported alliance during care predicted higher levels of professional-reported satisfaction and parent functioning but were not related to parent-reported outcomes. Change in parent-reported alliance was not related to outcomes. Conclusions Together, our findings suggest that a strong parent-professional alliance represents a key process factor in realizing positive outcomes of home-based parenting support. Consequently, efforts in research and practice are needed to investigate precursors of strong alliances and to optimize professionals’ ability to develop and maintain strong parent-professional alliances.15 p

Overview of CBT Spectrum Approaches

Cognitive behavioral therapy (CBT) is a psychosocial treatment with strong scientific evidence supporting its use with youth for a variety of emotional and behavioral problems. This chapter provides a broad overview of CBT with youth divided into three sctions. In the first section, the behavioral and cognitive theories that underlie the CBT approach are described. We also discuss how the two theories have been integrated into theories used to guide CBT. In the second section, a description of specific techniques commonly found in CBT is provided along with a review of the typical modalities employed to deliver CBT. Finally, the third section focuses on the delivery of CBT

Examining the relation between the therapeutic alliance, treatment adherence, and outcome of cognitive behavioral therapy for children with anxiety disorders

Little is known about the contribution of technical and relational factors to child outcomes in cognitive behavioral therapy (CBT) for children with anxiety disorders. This study investigated the association between treatment adherence, the child-therapist alliance, and child clinical outcomes in manual-guided individual- and group-based CBT for youths diagnosed with anxiety disorders. Trained observers rated tapes of therapy sessions for treatment adherence and child-therapist alliance in a sample of 52 children (aged 8 to 12) with anxiety disorders. Self-reported child anxiety was assessed at pre-, mid-, and posttreatment; parent-reported child internalizing symptoms was assessed at pre- and posttreatment. The results showed high levels of treatment adherence and child-therapist alliance in both CBT programs. Neither treatment adherence nor child-therapist alliance predicted traditional measurements of child outcomes in the present study, but a relation between alliance and outcome was found using a more precise estimation of the true pre-post differences. Implications of these findings for expanding our understanding of how treatment processes relate to child outcome in CBT for children with anxiety disorders are discussed