Measuring Psychodynamic-Interpersonal and Cognitive-Behavioral Techniques: Development of the Comparative Psychotherapy Process Scale.

Hilsenroth, Mark J.; Blagys, Matthew D.; Ackerman, Steven J.; Bonge, Dennis; Blais, Mark A.

doi:10.1037/0033-3204.42.3.340

Cited by 186 publications

(253 citation statements)

References 44 publications

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“…The psychometric properties of the CPPS have been well established in psychotherapy with adults. 82 Internal consistency of both scales has been good to excellent: Cronbach's α of 0.82 to 0.92 for the psychodynamic interpersonal scale and 0.75 to 0.94 for the cognitive-behavioural scale. 82,83 Inter-rater reliability is reported as rating from good to excellent [intraclass correlation coefficient (ICC) 0.60-0.75].…”

Section: Instruments Comparative Psychotherapy Process Scale -Externamentioning

confidence: 99%

“…82 Internal consistency of both scales has been good to excellent: Cronbach's α of 0.82 to 0.92 for the psychodynamic interpersonal scale and 0.75 to 0.94 for the cognitive-behavioural scale. 82,83 Inter-rater reliability is reported as rating from good to excellent [intraclass correlation coefficient (ICC) 0.60-0.75]. 83,84 In the current study, the CPPS was used to assess treatment fidelity for the CBT and STPP arms of the study and to assess treatment differentiation between all three treatment modalities used in IMPACT.…”

Section: Instruments Comparative Psychotherapy Process Scale -Externamentioning

confidence: 99%

“…82 These ratings were used to assess treatment fidelity for the CBT and STPP arms of the study and treatment differentiation between all three arms of the study. In addition, sessions from the BPI arm of the study were each rated by two raters, using a newly devised BPI fidelity measure in order to assess treatment fidelity to the BPI manual.…”

Section: Designmentioning

confidence: 99%

“…82 Developed from an extensive empirical review of the comparative psychotherapy process literature, 82 all items are rated on a 7-point Likert scale ranging from 0 ('not at all characteristic'), 2 ('somewhat characteristic'), 4 ('characteristic') to 6 ('extremely characteristic'). The 20-item measure includes 10 psychodynamic interpersonal items and 10 cognitive-behavioural items, forming two distinct subscales.…”

Section: Instruments Comparative Psychotherapy Process Scale -Externamentioning

confidence: 99%

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Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

Goodyer

Reynolds

Barrett

et al. 2017

Health Technol Assess

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BackgroundAlthough there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years.ObjectiveTo determine whether or not either of two specialist psychological treatments, cognitive–behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment.DesignObserver-blind, parallel-group, pragmatic superiority randomised controlled trial.SettingA total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London.ParticipantsAdolescents aged 11–17 years withDiagnostic and Statistical Manual of Mental Disorders-Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses.InterventionsIn total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up.Main outcome measuresMean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation.ResultsThere were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up = –0.578, 95% confidence interval (CI) –2.948 to 4.104;p = 0.748]. There were no superiority effects for the two specialist treatments (CBT + STPP) compared with BPI (treatment effect by final follow-up = –1.898, 95% CI –4.922 to 1.126;p = 0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49–52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome.ConclusionsThe three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings.LimitationsNeither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data.Trial registrationCurrent Controlled Trials ISRCTN83033550.FundingThis project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit toThe Lancet.

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Section: Instruments Comparative Psychotherapy Process Scale -Externamentioning

confidence: 99%

Section: Instruments Comparative Psychotherapy Process Scale -Externamentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

Section: Instruments Comparative Psychotherapy Process Scale -Externamentioning

confidence: 99%

See 2 more Smart Citations

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

Goodyer

Reynolds

Barrett

et al. 2017

Health Technol Assess

View full text Add to dashboard Cite

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“…Deeper session ratings have been positively correlated with higher likelihood for patient return after intake (Tryon, 1990), a stronger working alliance (Kivlighan et al, 2014;Mallinckrodt, 1993), and greater resolution of patient concerns (Mallinckrodt, 1993). Studies have shown that deeper session ratings are also positively associated with the use of psychodynamic-interpersonal techniques (e.g., Pesale & Hilsenroth, 2009), which include but are not limited to: exploring uncomfortable feelings, encouraging the patient to experience and express feelings in the therapy session, and addressing patient avoidance (Hilsenroth, Blagys, Ackerman, Bonge, & Blais, 2005). As discussed above, trainees high in FS may avoid using these techniques due to fear that the patient, unable to tolerate the discomfort these conversations invoke, will withdraw from the therapeutic relationship.…”

Section: Session Depthmentioning

confidence: 99%

You really are too kind: implications regarding friendly submissiveness in trainee therapists

Cain

Perkey

Widner³

et al. 2018

ResPsy

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To facilitate patient growth, therapists must immerse themselves in the patient’s world while also being able to see what is needed for change. This process requires finding a delicate balance between supporting and pushing patients. Therapists in training are additionally tasked with incorporating supervisors’ suggestions with their own views on what is needed to help their patients. Beginning therapists with tendencies to be overly accommodating may struggle to reconcile these competing demands. Thus, the aim of the present work is to explore how trainee friendly submissiveness (FS) interfaces with psychotherapy. Prior to training, clinical graduate trainee (n = 35) FS was assessed using the Inventory of Interpersonal Problems-32. Process and outcome data were then collected from each therapist’s first training case. Specifically, each trainee was assigned an undergraduate student volunteer with whom they had four non-manualized therapy sessions over the academic semester. After the third session, patients and trainees completed questionnaires assessing session impact and the working alliance, and two expert raters coded third session videotapes for techniques. Following termination, patients rated the overall helpfulness of the therapy. Trainee FS was significantly negatively associated with patient-rated depth, alliance, and overall helpfulness with moderate effects. Findings from a mediation analysis further suggested that trainees with higher FS struggled to focus the therapy in a way that felt productive to patients. Implications for clinical training are discussed.

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Some Effective Strategies for the Supervision of Psychodynamic Psychotherapy

Hilsenroth¹,

Diener²

2017

The Cycle of Excellence

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Measuring Psychodynamic-Interpersonal and Cognitive-Behavioral Techniques: Development of the Comparative Psychotherapy Process Scale.

Cited by 186 publications

References 44 publications

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

Cognitive–behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial

You really are too kind: implications regarding friendly submissiveness in trainee therapists

Some Effective Strategies for the Supervision of Psychodynamic Psychotherapy

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