Healing in a Social Context: The Importance of Clinician and Patient Relationship

Wampold, Bruce E.

doi:10.3389/fpain.2021.684768

Cited by 16 publications

(13 citation statements)

References 85 publications

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“…In psychotherapy, inter personal coregulation has been detected in momenttomoment emotional states of the patient and therapist 120,121 . Indeed, the beneficial effects of empathy in medicine have been attributed to coregulation 74,91,122 .…”

Section: The Caring Attentive Real and Empathic (Care) Pathwaymentioning

confidence: 99%

“…The verbal transmission of information about healthy behaviors is important in everyday life, as well as in health settings. Wampold 74 describes how the expectation that inserting a metal object into an electrical socket will create a painful shock is unlikely to have been acquired through classical conditioning or vicarious learning. Most people have learned not to insert metal objects into electrical sockets by being told by someone they trust, most likely a parent, that this was a dangerous practice.…”

Section: Mechanisms Of the Alliance And Clinical Actionsmentioning

confidence: 99%

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The alliance in mental health care: conceptualization, evidence and clinical applications

Wampold

Flückiger

2023

World Psychiatry

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The concept of alliance reflects the collaborative relationship between a clinician and a patient, defined as consisting of three elements: a) the agreement on the goals of treatment; b) the agreement on a task or series of tasks; c) the development of a bond. Although much of the theory and research on the alliance comes from the domain of psychotherapy, the concept is applicable to any practice involving a person seeking help and a socially sanctioned healer. An extensive research evidence suggests that the alliance (typically measured at the third or fourth session) is a robust predictor of the outcomes of various forms of psychotherapy, even when prior symptom improvement and other factors are considered. Both the clinician and the patient bring to the therapy situation different capacities to form an alliance. Factors concerning the patient include, among others, the diagnosis, attachment history and style, motivation, and needs for affiliation. However, the benefits of the alliance have been found to be mostly due to the therapist's contribution, in particular his/her facilitative interpersonal skills, including verbal fluency, communication of hope and positive expectations, persuasiveness, emotional expression; warmth, acceptance and understanding; empathy, and alliance rupture‐repair responsiveness. Placebo studies have allowed to experimentally manipulate aspects of the relationship between a therapist and a patient in non‐psychotherapy contexts. In these settings, two components of the relationship have emerged: an emotional one (involving being cared for and understood by the clinician) and a cognitive one (including the belief in the competence of the therapist to select and administer an effective treatment). Here we propose a model that describes three pathways through which the alliance creates benefits, named CARE (caring, attentive, real and empathic), EXPECTANCY, and SPECIFIC. Although research and clinical attention have mostly focused on the alliance between a clinician and a patient in face‐to‐face interactions, there is preliminary evidence concerning the alliance between patients and other clinic staff, systems of care, or the program in Internet‐mediated services. These new research areas clearly require further development.

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Section: The Caring Attentive Real and Empathic (Care) Pathwaymentioning

confidence: 99%

Section: Mechanisms Of the Alliance And Clinical Actionsmentioning

confidence: 99%

The alliance in mental health care: conceptualization, evidence and clinical applications

Wampold

Flückiger

2023

World Psychiatry

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“…Psychotherapy alleviates distress, facilitates adaptive coping, promotes more effective problem solving and decision making, and takes place within the interactive cultural context of the therapist and the client (Draguns, 1975). Psychotherapy is a culturally embedded healing practice and shares similarities with healing practices other than modern medicine (Wampold, 2001(Wampold, , 2021. Kleinman (1988) regarded "the explanatory model and negotiation" (p. 239) as essential to fully gain the client's perspective.…”

Section: Healing Psychotherapy and Counseling In Cultural Contextmentioning

confidence: 99%

Counseling Across Cultures: A Half-Century Assessment

Tanaka‐Matsumi

2022

Journal of Cross-Cultural Psychology

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As the Special Issue of the Journal of Cross-Cultural Psychology celebrates the 50th anniversary of the International Association for Cross-Cultural Psychology (IACCP), this article aims to summarize and track the development of counseling and psychotherapy in cultural contexts over the past half-century. When the edited volume, Counseling Across Cultures (CAC) first appeared nearly half a century ago, it sent an innovative message that culture matters in counseling and psychotherapy. The CAC editors produced six more updated editions in the succeeding years by 2016. The CAC authors examined the cultural context of accurate assessment, meaningful understanding of culture-relevant concepts, and appropriate interventions in each of the seven editions. They have surveyed universal and cultural aspects of counseling and psychotherapy according to such themes as emic and etic approaches to models of mental health, therapeutic relationships and techniques, assessment and interventions, and training needs against the IACCP’s ever-growing academic and professional activities. Research on the cultural adaptation of specific psychotherapies for specific clients should enhance access to culturally sensitive and evidence-based assessments and interventions. The need for training in multicultural awareness is expected to accelerate in the age of rapid globalization. This article affirms the contribution of the foundation-building approaches of CAC and the need for developing the interface between cross-cultural psychology and related clinical and counseling fields.

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“…Their study designs can decompose multicomponent treatments by comparing the complete intervention with an intervention in which one component is left out (dismantling studies) or with an intervention with an additional component (additive studies) (Bell et al, 2013 ; Mira et al, 2019 ). The effects of an intervention can be distinguished into specific effects and contextual, or non-specific, effects (Wampold, 2021 ). Specific effects are effects that are caused by the specific intervention, while contextual, or non-specific, effects result from factors that are not specific to the intended intervention and that appear in every intervention, such as treatment expectations, the therapeutic alliance (Rossettini et al, 2018 ; Wampold, 2021 ), novelty, demand characteristics, and effects from experimenters' expectations (Marino, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

“…The effects of an intervention can be distinguished into specific effects and contextual, or non-specific, effects (Wampold, 2021 ). Specific effects are effects that are caused by the specific intervention, while contextual, or non-specific, effects result from factors that are not specific to the intended intervention and that appear in every intervention, such as treatment expectations, the therapeutic alliance (Rossettini et al, 2018 ; Wampold, 2021 ), novelty, demand characteristics, and effects from experimenters' expectations (Marino, 2012 ). Such non-specific effects are considered as confounding variables that can affect internal and external validity (Carlino et al, 2011 ; Geers and Miller, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Specific and Non-specific Factors of Animal-Assisted Interventions Considered in Research: A Systematic Review

Wagner

Grob²,

Hediger³

2022

Front. Psychol.

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Research on animal-assisted interventions (AAIs) has increased massively in the last few years. But it is still not clear how AAIs work and how important the animal is in such interventions. The aim of this systematic review was to compile the existing state of knowledge about the working mechanisms of AAIs. We searched 12 major electronic databases for previous AAI studies with active control groups. Of 2001 records identified, we included 172 studies in the systematic review. We extracted previously published hypotheses about working mechanisms and factors that have been implicitly considered specific or non-specific in AAI research by categorizing control conditions using content analysis. We analyzed the categories using descriptive statistics. We found that 84% of the included studies mentioned a hypothesis of working mechanisms, but 16% did not define specific hypotheses. By analyzing their control conditions, we found that in most controlled studies, the animal or the interaction with the animal was implicitly considered as a specific factor for the effects of the AAI. Non-specific factors such as therapeutic aspects, social interactions, or novelty have also been controlled for. We conclude that AAI research still cannot answer the question of how and why AAIs work. To address this important research gap, we suggest using component studies with innovative control conditions and results from placebo research to address both the specific and non-specific, contextual factors of AAIs to disentangle its mechanisms.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=158103, identifier: CRD42020158103.

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Healing in a Social Context: The Importance of Clinician and Patient Relationship

Cited by 16 publications

References 85 publications

The alliance in mental health care: conceptualization, evidence and clinical applications

The alliance in mental health care: conceptualization, evidence and clinical applications

Counseling Across Cultures: A Half-Century Assessment

Specific and Non-specific Factors of Animal-Assisted Interventions Considered in Research: A Systematic Review

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