The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Strappini, Francesca; Socci, Valentina; Saliani, Angelo Maria; Grossi, Giuseppe; D’Ari, Giulia; Damato, Titti; Pompili, Nicole; Alessandri, Guido; Mancini, Francesco

doi:10.3389/fpsyt.2022.951925

Front. Psychiatry

2022

DOI: 10.3389/fpsyt.2022.951925

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The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Francesca Strappini

Valentina Socci

Angelo Maria Saliani³

et al.

Abstract: BackgroundThe therapeutic alliance has been recognized as one of the most researched key elements of treatment across different therapeutic approaches and diagnostic domains. Despite its importance, our current understanding of its clinical relevance in patients with obsessive-compulsive disorder (OCD) is still debated. This study aimed to examine empirical evidence on the effect of alliance on treatment outcomes in Cognitive Behavioral Therapy (CBT) in patients with OCD in a systematic review and meta-analysi… Show more

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Cited by 2 publications

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“…The therapeutic alliance is a cooperative relationship between the client and the therapist, which is reinforced by consensus on therapeutic objectives and therapeutic assignments, and a positive connection between the client and therapist (Strappini et al, 2022). In order to have treatment efficiency, adherence to the treatment is key.…”

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The Influence of Therapeutic Alliance in Psychotherapy

Loro Ortega

2023

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Psychotherapy is a treatment for mental illnesses that helps the person to reduce symptoms, improves daily functioning and overall well-being. The therapeutic alliance is an essential component of psychotherapy, it influences the clients' adherence and treatment efficiency. There are many elements that influence the development of the therapeutic alliance like the therapist characteristics and training. The therapist must establish rapport with the client and set with them realistic goals and recognize their improvement and accomplishments. Therapists with higher social skills are perceived as more efficient, the capacity to empathize, genuineness with theclient and understandment of client's concerns helped in the development of the therapeutic alliance and benefitted the therapy outcome. Training is key in the development of these skills, especially for therapists with low social abilities. Therapist should make sure to leave assumptions aside, avoid suppositions about beliefs and customs based on what is ¨known¨ about a specific group, consider cultural and religious beliefs, they should also be aware of possible bias they may have towards that specific group. Psychotherapists should try to understand the problem from the client’s point of view, given that if they feel misunderstood, this could be a barrier for the therapeutic alliance. Mental health specialists are responsible for creating a safe space and a cooperative relationship, so the client feels comfortable expressing their issues, set goals and for the effectiveness of therapy.

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The Influence of Therapeutic Alliance in Psychotherapy

Loro Ortega

2023

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Therapists’ problematic experiences when working with obsessive-compulsive disorder: a qualitative investigation of schema modes, mode cycles, and strategies to return to healthy adult mode

Semeniuc,

Sterie,

Soponaru

et al. 2023

Front. Psychiatry

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IntroductionObsessive-compulsive disorder (OCD) is one of the most challenging pathologies for therapists, being chronic and often characterized by frequent relapses. The therapeutic relationship plays a critical role in the outcome of therapy. The dynamic interaction between therapist and client schema modes determines the quality of the relationship.The objectiveof the present qualitative research is to investigate and conceptualize the triggers for therapists when working with OCD clients, the therapists’ schema modes that are activated, and the strategies they use to get back into the Healthy Adult mode.MethodUsing the in-depth interview technique, we interviewed 15 psychotherapists of various therapeutic orientations. After several demographic items, the therapists answered some introductory questions about their general perceptions of working with this pathology. They were then guided to go through a specific therapeutic situation in imagery that they identified as particularly difficult to manage in the therapeutic relationship. For data analysis, we used the interpretative phenomenological analysis (IPA) method and thematic analysis.ResultsFor therapists working with clients with OCD, two main categories of triggers have been identified: Perceived resistance to change and Superiority. Two other categories, Client immobilized by conflict and Abusive, emerged from our analysis. Therapists’ reactions to triggers were synthesized into mode processes that (1) were not acted on and (2) were displayed in relation with the client. For mode processes that therapists did not explicitly act on, there was triggering of the Vulnerable Child in relationship with a Demanding Parent, followed by various coping modes, depending on the category of trigger, and in the displayed mode, most therapists operated in the Healthy Adult mode. With respect to the process, strategies used by therapists to return to Healthy Adult mode that stood out were: focusing on the process, self-acceptance, self-compassion, and somatic grounding strategies, and focusing on the client’s resources.

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The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Cited by 2 publications

References 121 publications

The Influence of Therapeutic Alliance in Psychotherapy

The Influence of Therapeutic Alliance in Psychotherapy

Therapists’ problematic experiences when working with obsessive-compulsive disorder: a qualitative investigation of schema modes, mode cycles, and strategies to return to healthy adult mode

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