Therapeutic alliance as a mediator of change: A systematic review and evaluation of research

Baier, Allison L.; Kline, Alexander C.; Feeny, Norah C.

doi:10.1016/j.cpr.2020.101921

Cited by 213 publications

(177 citation statements)

References 98 publications

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“…Common factors are active across virtually all therapies and settings, whereas specific factors, as the name suggests, are more treatmentspecific (Cuijpers et al, 2019;Wampold, 2015). The most robust evidence on common factors has been found for therapeutic alliance and treatment expectancy (Baier et al, 2020;Constantino et al, 2018;Flückiger et al, 2018). Therapeutic alliance and treatment expectancy have also been shown to predict and mediate outcomes in the internet-based setting (Berger, 2017;Boettcher et al, 2013;El Alaoui et al, 2015Flückiger et al, 2018;Probst et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

Schaeuffele

Buengener

et al. 2021

Cogn Ther Res

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Background Transdiagnostic treatments target shared mechanisms between disorders to facilitate change across diagnoses. The Unified Protocol (UP) aims at changing dysfunctional reactions towards emotions by increasing mindful emotion awareness and cognitive flexibility, as well as decreasing anxiety sensitivity and emotion avoidance. Method We investigated whether these transdiagnostic processes were malleable by treatment and mediated the relationship between treatment and outcome in an internet-delivered adaptation of the UP. N = 129 participants with mixed anxiety, depressive, and somatic symptom disorders were randomized to treatment or waitlist. Results The treatment yielded significant changes in all transdiagnostic processes over time in comparison to a waitlist condition. In separate mediator models, significant mediating effects were found for mindfulness, cognitive flexibility, behavioral activation, and experiential avoidance. When all mediators were combined in a multiple mediator model, the indirect effects through mindfulness and cognitive flexibility emerged as significant. Conclusion These findings add to the growing body of research on transdiagnostic processes as mediators of change and emphasize mindfulness and cognitive flexibility as a transdiagnostic treatment target. However, these results should be interpreted cautiously, as temporal precedence could not be established.

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Section: Introductionmentioning

confidence: 99%

Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

Schaeuffele

Buengener

et al. 2021

Cogn Ther Res

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“…The literature also supports the mediating role of working alliance between coaching and outcomes (Baron & Morin, 2009;Byrd et al, 2010). The most recent systemic review by Baier et al (2020) confirms alliance as a mediator of change. Therefore, we conceptualise working alliance as a mediator in our model.…”

Section: Coaching Relationship: Working Alliancementioning

confidence: 82%

The impact of common factors on coaching outcomes

Molyn

Haan

Veen

et al. 2021

Coaching: An International Journal of Theory, Research and Prac

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Previous studies examining coaching outcomes generally rely on cross-sectional data which limits our understanding of the enduring and long-term effects of coaching. To address this issue, this study, based on longitudinal data, explores several popular variables associated with coaching outcomes. The study is underpinned by Lambert's [(1992). Lambert, M. J. (1992). Psychotherapy outcome research: Implications for integrative and eclectic therapists. In J. C. Norcross, & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94-129). Basic Books] four-factor model of common factors and recognises them as variables which are customary to all coaching approaches contributing to coaching outcomes. The study considers stress, wellbeing, resilience, goal attainment and coaching effectiveness as coaching outcomes. Working alliance mediates the impact of self-efficacy, outcome expectations; and perceived social support which are regarded as the predictors of the coaching outcomes. The results indicate that social support predicts working alliance, and working alliance in turn predicts wellbeing and coaching effectiveness over time. The findings suggest that it is vital for coaches to monitor changes in the coachees' social networks and their working alliance since these have a significant bearing on the effectiveness of the sessions and the coachees' wellbeing.

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“…Therapeutic alliance is one of the best predictors of treatment success and health outcomes [118][119][120]. Therapeutic alliance is broadly defined by the relationship between the provider and patient, fostered through mutual agreement of clinical goals and the strategies to achieve those goals [121].…”

Section: Xr Can Facilitate Telepresence To Strengthen Teletherapeutic Relationshipsmentioning

confidence: 99%

Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint

Ong¹,

Wilczewski²,

Paige³

et al. 2021

JMIR Serious Games

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The COVID-19 pandemic caused widespread challenges and revealed vulnerabilities across global health care systems. In response, many health care providers turned to telehealth solutions, which have been widely embraced and are likely to become standard for modern care. Immersive extended reality (XR) technologies have the potential to enhance telehealth with greater acceptability, engagement, and presence. However, numerous technical, logistic, and clinical barriers remain to the incorporation of XR technology into telehealth practice. COVID-19 may accelerate the union of XR and telehealth as researchers explore novel solutions to close social distances. In this viewpoint, we highlight research demonstrations of XR telehealth during the COVID-19 pandemic and discuss future directions to make XR the next evolution of remote health care.

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Therapeutic alliance as a mediator of change: A systematic review and evaluation of research

Cited by 213 publications

References 98 publications

Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

Transdiagnostic Processes as Mediators of Change in an Internet-Delivered Intervention Based on the Unified Protocol

The impact of common factors on coaching outcomes

Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint

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