Predicting premature termination of hospitalised treatment for anorexia nervosa: The roles of therapeutic alliance, motivation, and behaviour change

Sly, R. Michael; Morgan, John F.; Mountford, Victoria; Lacey, J. Hubert

doi:10.1016/j.eatbeh.2013.01.007

Cited by 68 publications

(67 citation statements)

References 39 publications

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“…Of the studies pertaining to the treatment of adult anorexia nervosa, two studies demonstrate support for the existence of an alliance-outcome association (Sly, Morgan, Mountford, & Lacey, 2013;Stiles-Shields et al, 2013). Sly and colleagues (2013) found that changes in the therapeutic alliance do not predict premature treatment termination.…”

Section: Anorexia Nervosamentioning

confidence: 97%

The Role of the Therapeutic Alliance in Eating Disorder Treatment Outcomes: A Systematic Review

et al. 2014

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The therapeutic alliance has proven to be an important construct in psychotherapy outcomes research for numerous psychiatric disorders. Given that dropout rates from treatment are especially high for individuals with eating disorders, it is critical to clarify the role that the therapeutic alliance plays in predicting treatment outcomes for this specific population. MEDLINE, CINAHL, and PsycINFO databases were systematically reviewed for studies that formally measured the therapeutic alliance construct and at least one other treatment variable in the context of eating disorder treatment. We identified 19 studies that indicate the therapeutic alliance may be an important factor in eating disorder treatment, yet reflect on the paucity of research on this topic in the context of treatment outcomes for both adult and adolescent populations. Current trends and limitations in the literature are highlighted to guide future research and ultimately improve clinical outcomes for patients with eating disorders.

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Section: Anorexia Nervosamentioning

confidence: 97%

The Role of the Therapeutic Alliance in Eating Disorder Treatment Outcomes: A Systematic Review

et al. 2014

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“…However, multiple studies have shown alliance to be relatively strong among patients with AN (Sly, Morgan, Mountford, & Lacey, 2013;Waller, et al, 2012). In fact, Antoniou and Cooper's qualitative review of the relationship between alliance and outcome in EDs (2013) suggested that the alliance strongly predicted outcome for patients with AN, whereas findings for BN, binge eating disorder (BED), and subthreshold eating disorders were mixed.…”

Section: Patient Diagnosismentioning

confidence: 99%

A meta‐analysis of the relation between therapeutic alliance and treatment outcome in eating disorders

Graves

Tabri

Thompson‐Brenner

et al. 2017

Intl J Eating Disorders

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136

139

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The therapeutic alliance has demonstrated an association with favorable psychotherapeutic outcomes in the treatment of eating disorders (EDs). However, questions remain about the interrelationships between early alliance, early symptom improvement, and treatment outcome. We conducted a meta-analysis on the relations among these constructs, and possible moderators of these relations, in psychosocial treatments for EDs. Twenty studies met inclusion criteria and supplied sufficient supplementary data. Results revealed small-to-moderate effect sizes, bs 5 0.13 to 0.22 (p < .05), indicating that early symptom improvement was related to subsequent alliance quality and that alliance ratings also were related to subsequent symptom reduction. The relationship between early alliance and treatment outcome was partially accounted for by early symptom improvement. With regard to moderators, early alliance showed weaker associations with outcome in therapies with a strong behavioral component relative to nonbehavioral therapies.However, alliance showed stronger relations to outcome for younger (vs. older) patients, over and above the variance shared with early symptom improvement. In sum, early symptom reduction enhances therapeutic alliance and treatment outcome in EDs, but early alliance may require specific attention for younger patients and for those receiving nonbehaviorally oriented treatments.Resumen: Objetivo: La alianza terap eutica entre paciente y terapeuta ha demostrado ser una relaci on con resultados psicoterap euticos favorables en el tratamiento de los trastornos de la conducta alimentaria (TCA). Sin embargo, quedan preguntas acerca de la inter-relaci on entre alianza temprana, mejoría temprana de síntomas y resultados del tratamiento. Hicimos un meta-an alisis de la relaci on entre estos constructos y los posibles moderadores de estas relaciones en los tratamientos psicosociales para TCA. M etodo: Veinti un estudios reunieron los criterios de inclusi on y aportaron suficientes datos suplementarios. Resultados: los resultados revelaron un efecto de la talla pequeño a moderado, b 5 0.13 a 0.22 (p < .05), encontrando que la mejoría temprana de los síntomas estuvo relacionada con la subsecuente calidad de la alianza y las calificaciones de la alianza tambi en estuvieron relacionadas con la subsecuente reducci on de los síntomas. La relaci on entre alianza temprana y resultados de tratamiento fue parcialmente explicada por la temprana mejoría de los síntomas. Con relaci on a los moderadores, la alianza temprana mostr o d ebiles asociaciones con el resultado en terapias con un fuerte componente conductual relativo a terapias no conductuales. Sin embargo, la alianza mostr o m as fuerte relaci on con los resultados para pacientes m as j ovenes (versus mayores), por encima y sobre la varianza compartida con la temprana mejoría de síntomas. Discusi on: En resumen, la reducci on temprana de los síntomas refuerza la alianza terap eutica y los resultados del tratamiento en TCA, pero la alianza temprana puede reque...

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“…Hay et al, 2012;Sly et al, 2013;Stiles-Shields et al, 2013) and associated interpersonal difficulties Swinbourne and Touyz, 2007). These difficulties interfere with treatment response and are accentuated by the neuroprogressive changes due to starvation (e.g.…”

Section: Introductionmentioning

confidence: 97%

A preliminary investigation of a novel training to target cognitive biases towards negative social stimuli in Anorexia Nervosa

Cardi

Esposito

Bird

et al. 2015

Journal of Affective Disorders

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Predicting premature termination of hospitalised treatment for anorexia nervosa: The roles of therapeutic alliance, motivation, and behaviour change

Cited by 68 publications

References 39 publications

The Role of the Therapeutic Alliance in Eating Disorder Treatment Outcomes: A Systematic Review

The Role of the Therapeutic Alliance in Eating Disorder Treatment Outcomes: A Systematic Review

A meta‐analysis of the relation between therapeutic alliance and treatment outcome in eating disorders

A preliminary investigation of a novel training to target cognitive biases towards negative social stimuli in Anorexia Nervosa

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