Goal consensus and collaboration.

Abstract

This article updates our previous article in this journal (Tryon & Winograd, 2001) by examining via meta-analyses results of recent studies, published from 2000 through 2009, that relate goal consensus and collaboration to treatment outcome. Specifically, 15 studies with a total sample size of 1,302 yielded a goal consensus-psychotherapy outcome effect size of .34 (SD = .19, p < .0001, 95% confidence interval = .23-.45), indicating that better outcomes can be expected when patient and therapist agree on therapeutic goals and the processes to achieve these goals. The collaboration-outcome meta-analysis based on 19 studies with a total sample of 2,260 patients yielded a mean correlation of .33 (SD = .17, p < .0001, 95% confidence interval = .25-.42), suggesting that psychotherapy outcome appears to be considerably enhanced when patient and therapist are actively involved in a cooperative relationship. We discuss therapeutic practices that follow from these findings.

The working alliance: Where have we been, where are we going?

“…The strength of the alliance demonstrates a modest but consistent impact on psychotherapy outcome, with meta-analytic effect sizes ranging from .22 to .27 (Horvath et al, 2011;Horvath & Symonds, 1991;Martin, Garske, & Davis, 2000). Additionally, metaanalytic findings (Tryon & Winograd, 2011) have demonstrated that patient and therapist agreement on the goals and tasks of therapy enhance treatment outcome (p. 34), as does engagement in an active cooperative relationship (p. 33). Researchers have concluded that the working alliance is an essential ingredient in producing therapeutic change (Horvath & Greenberg, 1986;Lambert & Barley, 2001;Lambert & Simon, 2008;Norcross, 2002).…”

Experiences of engaging in psychotherapeutic interventions for sexual offending behaviours: A meta-synthesis

“…Research has shown that therapy is most effective when goals are set collaboratively (Tryon & Winograd, 2011), but sex offenders who participate in structured group programmes rarely have any input into their therapy goals. When individuals have the opportunity to engage in open-ended groups (which allow greater individualisation of treatment) compared to closed groups (where the time spent on each therapeutic target is determined by the needs of the whole group), attrition rates are lower, and facilitators report they are able to develop more effective and enduring therapeutic relationships, thereby enhancing treatment processes (Ware, Mann, & Wakeling, 2009).…”

Introduction to the Special Issue on Processes of Cognitive Behavioral Therapy: Does “Necessary, But Not Sufficient” Still Capture It?

“…For example, while studies have considered the causal benefits of including homework in CBT , correlational adherence-outcome relations (Kazantzis et al 2016;Mausbach et al 2010), and session-by-session benefits associated with homework adherence (Conklin and Strunk 2015), more research is needed on the in-session therapist behaviors that can facilitate engagement Startup and Edmonds 1994;and see;Shaw et al 1999 for evidence of competence in structuring sessions as a predictor of outcomes). Similarly, existing measures may not fully capture the definition of collaboration in CBT (Kazantzis et al 2015;Tryon and Winograd 2011), the evidence for Socratic dialogue is just emerging (Braun et al 2014), and study of feedback processes has centered on symptom assessments (Knaup et al 2009;Lambert and Shimokawa 2011).…”