Psychotherapy techniques related to therapist alliance among adolescents with eating disorders: The utility of integration.

Abstract

This study is the 1st to explore specific therapeutic techniques clinicians find helpful in establishing and maintaining alliance with adolescents with eating disorders. Data was collected from 107 experienced therapists (M years ϭ 16) currently treating an eatingdisordered adolescent. Therapists held degrees in various disciplines in mental health (MA, MS, MSW, MHC, PhD, PsyD) or in medicine (MD), who came from various theoretical orientations (cognitive-behavioral [CB] ϭ 46.7%, psychodynamic ϭ 13.1%, interpersonal ϭ 13.1%, family ϭ 7.5%, humanistic ϭ 3.7%, and other ϭ 15.9%). Therapists rated the utility of various psychodynamicϪinterpersonal, CB, and adjunctive eating disorder interventions, as well as their alliance with that patient. The majority of the patients (N ϭ 107) reported on were female (n ϭ 102) and diagnosed with anorexia (n ϭ 70), bulimia (n ϭ 14), binge eating (n ϭ 9), or other specified feeding or eating disorders (n ϭ 14). Therapists reported a constellation of integrative treatment interventions related to alliance. Specifically, a forward stepwise regression yielded a final, 7-step model predicting therapist alliance (R ϭ .704, r 2 ϭ .495), F(102) ϭ 4.599, p ϭ .035. The final regression model revealed specific items from each treatment approach to be significantly related to alliance, with the most important item being an in-session focus on the therapeutic relationship. Findings highlight how an integrative model of treatment interventions, with emphasis on the focus of the therapistϪpatient relationship in session, might be explored in future work to help facilitate the alliance in the treatment of adolescents with eating disorders.

Validation of the German version of the Comparative Psychotherapy Process Scale.

“…It could also become clearer which differentiating PD and which differentiating CBT interventions are particularly related to psychotherapy successes (also with reference to specific mental illnesses; e.g., the focus on affect and the expression of patients’ emotions: e.g., Biel et al, 2023; Henley, 2023; Reininger et al, 2023). This intervention psychotherapy-success link could possibly inform integrative efforts, such as the establishment of a psychotherapeutic alliance independent of the psychotherapeutic procedure (Groth et al, 2020; Groth & Hilsenroth, 2021). Furthermore, it seems sustainably interesting to investigate prospectively which features are applied at which point in the course of therapy, and which variables of patient satisfaction and psychotherapy success they can predict and for whom and how (e.g., Coyne et al, 2022; Tal et al, 2023).…”

First-Session Therapeutic Relationship and Outcome in High Risk Adolescents Intensive Group Psychotherapeutic Programme

“…In the intake process it seems crucial to establish a good quality therapeutic relationship to increase the chance of an average or high treatment outcome. Maybe for high risk adolescents with personality disorders and insecure attachment ( Hauber et al, 2018 ) an intense focus on the therapeutic relationship from the start of treatment is extra helpful in establishing and maintaining alliance ( Groth and Hilsenroth, 2019 ; Hauber et al, 2020 ). Therapeutic ruptures can quickly be repaired and drop out of treatment prevented ( Hauber et al, 2020 ).…”

Facilitative interpersonal skills are relevant in child therapy too, so why don’t we measure them?

“…In qualitative interviews, children in therapy noted that the ability to talk to a therapist, the therapeutic relationship and the space to play were most central to their positive change (Capella et al ., 2018 ). Attending to what was happening in the therapeutic relationship, including talking about and processing the relationship, is considered by therapists across orientations to be the most important factor in promoting the alliance with adolescent patients (Groth & Hilsenroth, 2021 ).…”