The perceived importance of alliance and technique adherence within cognitive behavioural therapy: A comparison of patients’ and therapists’ beliefs

Alliance and adherence to therapeutic techniques are key elements of Cognitive Behavioural Therapy (CBT). Therapists’ beliefs about how important alliance and technique adherence are throughout CBT might impact how they deliver therapy. Furthermore, these beliefs might or might not be congruent with patients’ therapy-related beliefs. This research investigated whether therapists hold similar beliefs to patients regarding the importance of alliance and technique adherence throughout CBT and whether therapists could accurately predict patients’ beliefs. CBT therapists (n = 103) and CBT patients (n = 181) rated the importance of alliance and technique adherence to CBT outcomes in early, mid and late therapy. Therapists also predicted patients’ responses. Mann-Whitney U tests compared therapists’ responses and therapists’ predictions with patients’ responses at each stage of therapy. Therapists rated alliance and technique adherence as more important than patients did throughout therapy, with the largest discrepancy for alliance in early therapy. Therapists accurately predicted patients’ alliance importance ratings but underestimated patients’ technique adherence importance ratings for early and mid-therapy. Therapists are encouraged to challenge their assumptions about patients’ therapy-related beliefs by having open discussions with patients. Therapists are encouraged to prioritise technique adherence as well as alliance in early CBT

Deviance partitioning of host factors affecting parasitization in the European brown hare (Lepus europaeus)

Deviance partitioning can provide new insights into the ecology of host-parasite interactions. We studied the host-related factors influencing parasite prevalence, abundance, and species richness in European brown hares (Lepus europaeus) from northern Spain. We defined three groups of explanatory variables: host environment, host population, and individual factors. We hypothesised that parasite infection rates and species richness were determined by different host-related factors depending on the nature of the parasite (endo- or ectoparasite, direct or indirect life cycle). To assess the relative importance of these components, we used deviance partitioning, an innovative approach. The explained deviance (ED) was higher for parasite abundance models, followed by those of prevalence and then by species richness, suggesting that parasite abundance models may best describe the host factors influencing parasitization. Models for parasites with a direct life cycle yielded higher ED values than those for indirect life cycle ones. As a general trend, host individual factors explained the largest proportion of the ED, followed by host environmental factors and, finally, the interaction between host environmental and individual factors. Similar hierarchies were found for parasite prevalence, abundance, and species richness. Individual factors comprised the most relevant group of explanatory variables for both types of parasites. However, host environmental factors were also relevant in models for indirect life-cycle parasites. These findings are consistent with the idea of the host as the main habitat of the parasite; whereas, for indirect life-cycle parasites, transmission would be also modulated by environmental conditions. We suggest that parasitization can be used not only as an indicator of individual fitness but also as an indicator of environmental quality for the host. This research underlines the importance of monitoring parasite rates together with environmental, population, and host factors.This study was supported by the Cantabria Government. V. Alzaga received a grant from Cantabria Government; P. Tizzani enjoyed a grant from Leonardo programme during IREC period; P. Acevedo is currently enjoying a Juan de la Cierva research contract awarded by the Ministerio de Ciencia e Innovación (MICINN) and is also supported by the project CGL2006-09567/BO; and F. Ruiz-Fons is supported by the “Instituto de Salud Carlos III” from the Ministerio de Sanidad y Consumo.Peer reviewe