Psychotherapy role expectations and experiences – Discrepancy and therapeutic alliance among patients with substance use disorders

Frankl, My; Philips, Björn; Wennberg, Peter

doi:10.1111/papt.12021

Cited by 8 publications

(4 citation statements)

References 49 publications

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“…The mean of each subscale is used as the score of the subscale, thus with the range 1 to 6. Internal consistency for the subscales and the factor structure of the short PEX are satisfactory (Frankl, Philips, & Wennberg, 2013).…”

Section: Methodsmentioning

confidence: 99%

The importance of therapy motivation for patients with substance use disorders.

Philips¹,

Wennberg²

2014

Psychotherapy

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The present study aimed to examine whether patients' pretherapy motivation was related to other patient characteristics and whether it predicted retention in psychotherapy. Data were collected within a naturalistic outcome study of various forms of psychotherapy for patients (N = 172) with substance use disorders (SUD). Therapy motivation was measured using the Client Motivation for Therapy Scale (CMOTS), including the variables autonomous motivation, controlled motivation, and amotivation. Female patients had higher levels of autonomous motivation (d = .53), lower levels of controlled motivation (d = -.32), and lower levels of amotivation (d = -.62). Level of symptoms and impairment was significantly positively correlated with controlled motivation (r = .31). Autonomous motivation was positively correlated with four expectation subscales associated with constructive therapeutic work, whereas amotivation was negatively correlated with three of these subscales. Controlled motivation was positively correlated with the subscales external orientation, defensiveness, and support. In a logistic regression, amotivation stood out as a negative predictor of retention, in terms of starting in psychotherapy after assessment or not. Quite surprisingly, autonomous motivation was not a significant predictor of retention. The present study indicates that amotivation is a risk factor for early dropout among SUD patients. More efforts should be directed at preparing patients for psychotherapy through strengthening motivation.

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Section: Methodsmentioning

confidence: 99%

The importance of therapy motivation for patients with substance use disorders.

Philips¹,

Wennberg²

2014

Psychotherapy

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“…La investigación en psicoterapia en adultos ha desarrollado un modelo genérico del cambio psicoterapéutico, que se refiere a factores comunes del cambio presentes en todos los procesos psicoterapéuticos -independientes de su modalidad teórica-que influyen en los procesos y resultados de la terapia, y que son aportados por el paciente, el terapeuta y el contexto donde ésta se realiza (Orlinsky & Howard, 1987). Respecto a los pacientes, la investigación ha mostrado que sus expectativas frente al proceso son un factor relevante para su evolución y resultados (Asay & Lambert, 1999;Frankl, Philips, & Wennberg, 2014). Expectativas entendidas como las creencias anticipatorias que los pacientes traen previamente a la psicoterapia sobre el procedimiento, los resultados, el terapeuta o cualquier otro aspecto de la intervención psicológica y su implementación (Krause, 2005;Nock & Kazdin, 2001).…”

Section: Introductionunclassified

Expectativas de niños y padres consultantes frente a la psicoterapia infantil

2021

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El objetivo de la presente investigación fue analizar cualitativamente las expectativas de niños y sus padres frente a la psicoterapia infantil desde la perspectiva de cada uno de ellos, y relacionar los elementos que intervienen en el proceso de construcción de dichas expectativas. Los participantes de este estudio fueron 10 díadas compuestas por niños entre 7 a 10 años y sus padres. La información se recolectó a través de un total de 20 entrevistas semiestructuradas, realizadas en forma independiente a cada participante antes de la sesión de ingreso a la terapia. Se realizó un análisis cualitativo de la información basándose en procedimientos de codificación abierta y axial propuestos por la Teoría Fundamentada. Los resultados muestran que los niños desarrollan expectativas sobre el proceso y los resultados, a partir de las experiencias previas con psicólogos y de la información entregada por los padres acerca de la función del psicólogo como “alguien que ayuda”. Los resultados esperados por los niños son “sentirse mejor” y relacionarse mejor con los pares. En el caso de los padres sus expectativas se construyen con base en experiencias psicológicas previas y la información obtenida del contexto sociocultural. Estas experiencias influyen en su visión psicológica del problema de su hijo y en una percepción de la función del psicólogo como un profesional que ayuda, no sólo a su hijo, sino también a ellos en el desarrollo de habilidades parentales. Además, a partir de estas experiencias los padres esperan tener un rol más participativo en el proceso de sus hijos.

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“…The total score ranges from 25-150). All subscales in the PEX-S have shown satisfactory internal consistency, with Cronbach's alpha ranging between .79 and .84 (Frankl et al, 2014).…”

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confidence: 99%

“…Psychotherapy Expectations and Experiences Scale-short version (PEX-S; (Clinton & Sandell, 2003;Frankl, Philips, & Wennberg, 2014) was used for assessing patients' treatment expectations at pre-treatment, as well as their experiences of therapy, measured at follow-up. PEX-S is a 25-item instrument distributed on five subscales.…”

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confidence: 99%

Affect Phobia Therapy for Mild to Moderate Alcohol Use Disorder: The Cases of "Carey," "Michelle," and "Mary"

Frankl¹,

Wennberg²,

Berggraf³

et al. 2020

PCSP

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Affect Phobia Treatment (APT) is based on an integrative theory involving the use of psychodynamic principles for understanding a client’s psychological dynamics, experiential principles for engaging and working with the client’s affect, and behavioral principles of exposure and response prevention for desensitizing the client to the fear of affect. APT’s goal is "to help patients function better by resolving emotional conflict through reducing their avoidance of adaptive, activating emotions" (Osborn et al., 2014). APT has not yet been systematically employed and researched for patients with mild to moderate Alcohol Use Disorder (AUD) together with affect phobia. The present study was designed to begin this process by describing and comparing, both qualitatively and quantitatively, three illustrative, distinctive cases of APT in patients with AUD, assigned the names of "Carey," "Michelle," and "Mary." The focus was on exploring the process by which the different individual patients responded to the multifaceted APT therapy, and hence how the therapist had to adapt the therapy to each particular patient, as outlined in Stiles’ (2009) concept of "appropriate responsiveness." Following the manual for APT, therapy included 10 weekly sessions of individual psychotherapy. This short length for a therapy like APT, a treatment which usually has no determined session length (McCullough et al., 2003), was designed to make the therapy comparable in length to other therapies for AUD, like Motivational Interviewing. During the whole study period, patients gave weekly reports of their alcohol consumption and craving. In addition, at the beginning and at the end of the study, the patients answered questionnaires measuring affect phobia and psychiatric symptoms. Role expectations and experiences of psychotherapy were also measured. All three patients completed the treatment and the measurement period. No adverse events were reported. The patients had different trajectories of change regarding alcohol consumption, craving, and symptom change. The study showed that 10-session APT was a tolerable treatment for the patients with on-going mild-to-moderate alcohol dependence, who primarily used alcohol as a way of avoiding emotions, but that the therapy worked to different degrees and in different ways for the three patients due to their different presenting patterns of psychiatric symptoms and personality characteristics. Experience in the three cases suggests the advisability of (a) flexible treatment length in accordance to a patient's needs, and (b) complementary treatment strategies beyond APT focusing on reducing alcohol consumption per se for some patients.

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Psychotherapy role expectations and experiences – Discrepancy and therapeutic alliance among patients with substance use disorders

Cited by 8 publications

References 49 publications

The importance of therapy motivation for patients with substance use disorders.

The importance of therapy motivation for patients with substance use disorders.

Expectativas de niños y padres consultantes frente a la psicoterapia infantil

Affect Phobia Therapy for Mild to Moderate Alcohol Use Disorder: The Cases of "Carey," "Michelle," and "Mary"

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