Therapeutic Alliance in Family Therapy for Adolescents with Epilepsy: An Exploratory Study

Glueckauf, Robert L.; Liss, Heidi J.; McQuillen, Diane E.; Webb, Pat M.; Dairaghi, Jeanne; Carter, Carol B.

doi:10.1080/019261802753573849

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…Independent raters judged therapist adherence and competence to be high across all workshops. The results from these evaluations are comparable to results found using the same measures in studies with similar methodologies and goals (Friedman, 2005;Glueckaf et al, 2002;Weisman et al, 1998). Consistent with the findings of previous research, participant knowledge increased, specifically about symptoms of the disorder, despite the fact that the sample was highly knowledgeable before the study (Bernhard et al, 2006;Reinares et al, 2004).…”

Section: Discussionsupporting

confidence: 87%

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An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

Eisner

Johnson

2008

Behavior Therapy

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Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric disorders. There is also substantial research to suggest that anger can drive blaming attributions. Combining these ideas, this study built on previous psychoeducation interventions through the addition of an acceptance component designed to decrease anger and blaming attributions among family members of those with bipolar disorder. Twenty-eight family members attended a 1-day or 2-evening multifamily group workshop and completed a followup assessment 1 week later. At follow-up, participants demonstrated more knowledge about bipolar disorder. Anger, blaming attributions, and number of criticisms remained unchanged. Results of this study are consistent with others in that it is difficult to change EE. Implications for future clinical research in this area are addressed.The construct of expressed emotion (EE) is defined as critical, hostile, or emotionally overinvolved (EOI) attitudes toward a relative with a psychiatric disorder (Hooley, Rosen, & Richters, 1995). EE has been linked with poor patient outcome for several psychiatric disorders (Barrowclough & Hooley, 2003;Butzlaff & Hooley, 1998). Butzlaff and Hooley (1998) found a meta-analytic effect size of r=.39 across six studies that examined the relationship between EE and relapse within mood disorders. More recent research suggests that, although EE was unrelated to manic relapse, high EE was related to a five-fold increase in the odds of a depressive recurrence, even after controlling for symptom severity (Yan, Hammen, Cohen, Daley, & Henry, 2004). Criticism has been found to be the most important element of EE for understanding the course of mood disorders (Hooley et al., 1995) and for bipolar depression (Kim & Miklowitz, 2004). Thus, EE has an influence on bipolar relapse, more specifically for depression.What drives high levels of criticism? According to Weiner's (1995) attribution-affect model, attributions influence the way people experience emotion. In particular, when an individual perceives that another person is in control of his or her behavior, this leads to a judgment that the other person is responsible for his or her behavior. A judgment that the other person is responsible elicits anger and criticism. High EE relatives who are critical have a tendency to view symptoms of mental illness as behaviors that are within the patient's control (Barrowclough, Johnston, & Tarrier, 1994). Because high EE relatives believe the patient is in control of his or her behavior, they believe the patient must also be capable of modifying this behavior. Thus, relatives struggle to normalize the patient's behavior through negative feedback and controlling behavior of their own (Hooley & Campbell, 2002 Several studie...

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Section: Discussionsupporting

confidence: 87%

supporting

confidence: 80%

An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

Eisner

Johnson

2008

Behavior Therapy

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“… Friedlander et al ( 2008 ) 3 27 Mixed R 10.2 n.r. 33 7 10 Friedlander et al ( 2012 ) 3 20 Mixed R 13.2 33 41 10 11 Glueckauf et al ( 2002 ) 19 Epilepsy with behavioral problems R 13.9 53 41 11 n.r. Hawley and Weisz ( 2005 ) 65 Mixed HS 11.9 59 11 63 n.r.…”

Section: Methodsmentioning

confidence: 99%

Alliance and Treatment Outcome in Family-Involved Treatment for Youth Problems: A Three-Level Meta-analysis

Poll

Roest

Stouwe

et al. 2017

Clin Child Fam Psychol Rev

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Alliance has been shown to predict treatment outcome in family-involved treatment for youth problems in several studies. However, meta-analytic research on alliance in family-involved treatment is scarce, and to date, no meta-analytic study on the alliance–outcome association in this field has paid attention to moderating variables. We included 28 studies reporting on the alliance–outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N = 2126 families, M age youth ranging from 10.6 to 16.1). We performed three multilevel meta-analyses of the associations between three types of alliance processes and treatment outcome, and of several moderator variables. The quality of the alliance was significantly associated with treatment outcome (r = .183, p < .001). Correlations were significantly stronger when alliance scores of different measurement moments were averaged or added, when families were help-seeking rather than receiving mandated care and when studies included younger children. The correlation between alliance improvement and treatment outcome just failed to reached significance (r = .281, p = .067), and no significant correlation was found between split alliances and treatment outcome (r = .106, p = .343). However, the number of included studies reporting on alliance change scores or split alliances was small. Our findings demonstrate that alliance plays a small but significant role in the effectiveness of family-involved treatment. Future research should focus on investigating the more complex systemic aspects of alliance to gain fuller understanding of the dynamic role of alliance in working with families.

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“…Alcoholics Anonymous (AA), has a strongly narrative approach (Rappaport, 1993;Davis & Jansen, 1998), and is significantly effective in treating alcoholism (Emrick, et al, 1993;Montgomery, Miller & Tonigan, 1995;Snow, Prochaska & Rossi, 1994). Further review of the literature also indicates that narrative therapy is inherently respectful to the client and encourages collaboration, or alliance with the therapist, rather than antagonism (Glueckauf, Liss, McQuillen, Webb, Dairaghi, & Carter, 2002). This therapeutic or working alliance promotes client satisfaction with therapy, which some consider the "bottom line" in defining successful therapy (Barnard & Kuehl, 1995).…”

Section: Hypothesesmentioning

confidence: 99%

“…The quality of children's' affective relationship with therapists has been associated with collaboration (alliance) in therapy, but not enough research has been conducted on the kinds of therapeutic techniques which promote therapeutic alliance in young clients (Shirk & Saiz, 1992). A recent study found therapeutic alliance to be positively associated with therapy outcomes in family therapy with adolescent epilepsy patients (Glueckauf, Liss, McQuillen, Webb, Dairaghi, & Carter, 2002). Other authors have emphasized the need for counselors to develop a strong therapeutic alliance with adolescents in order to be effective helpers for teens in crisis (Manley & Leichner, 2003).…”

Section: Implications and Connections Inherent To Narrative Therapymentioning

confidence: 99%

Narrative group therapy with outpatient adolescents

Kaptain

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Therapeutic Alliance in Family Therapy for Adolescents with Epilepsy: An Exploratory Study

Cited by 17 publications

References 22 publications

An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

Alliance and Treatment Outcome in Family-Involved Treatment for Youth Problems: A Three-Level Meta-analysis

Narrative group therapy with outpatient adolescents

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