| Title |
Expectancies, Working Alliance, and Outcome in Transdiagnostic and Single Diagnosis Treatment for Anxiety Disorders: An Investigation of Mediation
|
|---|---|
| Published in |
Cognitive Therapy and Research, April 2017
|
| DOI | 10.1007/s10608-017-9855-8 |
| Pubmed ID | |
| Authors |
Shannon Sauer-Zavala, James F. Boswell, Kate H. Bentley, Johanna Thompson-Hollands, Todd J. Farchione, David H. Barlow |
| Abstract |
Patients' outcome expectancies and the working alliance are two psychotherapy process variables that researchers have found to be associated with treatment outcome, irrespective of treatment approach and problem area. Despite this, little is known about the mechanisms accounting for this association, and whether contextual factors (e.g., psychotherapy type) impact the strength of these relationships. The primary aim of this study was to examine whether patient-rated working alliance quality mediates the relationship between outcome expectancies and pre- to post-treatment change in anxiety symptoms using data from a recent randomized clinical trial comparing a transdiagnostic treatment (the Unified Protocol [UP]; Barlow et al., 2011a; Barlow, Sauer-Zavala, et al., in press) to single diagnosis protocols (SDPs) for patients with a principal heterogeneous anxiety disorder (n = 179). The second aim was to explore whether cognitive-behavioral treatment condition (UP versus SDP) moderated this indirect relationship. Results from mediation and moderated mediation models indicated that, when collapsing across the two treatment conditions, the relationship between expectancies and outcome was partially mediated by the working alliance (B = .037, SE = .05, 95% CI [.005, .096]). Interestingly, within-condition analyses showed that this conditional indirect effect was only present for SDP patients, whereas in the UP condition, working alliance did not account for the association between expectancies and outcome. These findings suggest that outcome expectancies and working alliance quality may interact to influence treatment outcomes, and that the nature and strength of the relationships among these constructs may differ as a function of the specific cognitive-behavioral treatment approach utilized. |
Mendeley readers
The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 86 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 12 | 14% |
| Student > Master | 12 | 14% |
| Researcher | 10 | 12% |
| Student > Bachelor | 8 | 9% |
| Student > Doctoral Student | 8 | 9% |
| Other | 14 | 16% |
| Unknown | 22 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Psychology | 42 | 49% |
| Medicine and Dentistry | 7 | 8% |
| Unspecified | 3 | 3% |
| Nursing and Health Professions | 3 | 3% |
| Neuroscience | 2 | 2% |
| Other | 2 | 2% |
| Unknown | 27 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 April 2017.
All research outputs
#21,358,731
of 23,854,458 outputs
Outputs from Cognitive Therapy and Research
#875
of 953 outputs
Outputs of similar age
#273,509
of 312,450 outputs
Outputs of similar age from Cognitive Therapy and Research
#13
of 20 outputs
Altmetric has tracked 23,854,458 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 953 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.9. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 312,450 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 20 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.