Competence in delivering Cognitive Processing Therapy and the therapeutic alliance both predict PTSD symptom outcomes

The effect of early therapeutic alliance on treatment dropout in cognitive processing therapy and client factors as moderators of this relationship

10.32920/ryerson.14661918.v1 ◽

2021 ◽

Author(s):

Iris Sijercic

Keyword(s):

Therapeutic Alliance ◽

Cognitive Processing ◽

Ptsd Symptom ◽

Dropping Out ◽

Cognitive Processing Therapy ◽

Treatment Dropout ◽

Client Factors ◽

Ptsd Symptom Severity ◽

The Relationship ◽

Implementation Trial

Although efficacious treatments, including Cognitive Processing Therapy (CPT), are available for treating Posttraumatic Stress Disorder (PTSD), a substantial number of clients do not receive a full course of CPT due to clients dropping out prematurely. Examining factors associated with treatment dropout may increase our understanding on how to tailor interventions to prevent treatment dropout. This study examined the relationship between early therapeutic alliance and treatment dropout, and client age and pretreatment PTSD symptom severity as predictors of dropout and moderators of the alliance-dropout association. Clients were part of a larger randomized implementation trial, and either began CPT and dropped out (n = 38) or completed 12 sessions of CPT (n = 74). Results indicated early therapeutic alliance did not significantly predict treatment dropout, and age and PTSD severity were not significant predictors or moderators of the alliance-dropout association. Clinical implications of the findings are discussed.

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The effect of early therapeutic alliance on treatment dropout in cognitive processing therapy and client factors as moderators of this relationship

10.32920/ryerson.14661918 ◽

2021 ◽

Author(s):

Iris Sijercic

Keyword(s):

Therapeutic Alliance ◽

Cognitive Processing ◽

Ptsd Symptom ◽

Dropping Out ◽

Cognitive Processing Therapy ◽

Treatment Dropout ◽

Client Factors ◽

Ptsd Symptom Severity ◽

The Relationship ◽

Implementation Trial

Although efficacious treatments, including Cognitive Processing Therapy (CPT), are available for treating Posttraumatic Stress Disorder (PTSD), a substantial number of clients do not receive a full course of CPT due to clients dropping out prematurely. Examining factors associated with treatment dropout may increase our understanding on how to tailor interventions to prevent treatment dropout. This study examined the relationship between early therapeutic alliance and treatment dropout, and client age and pretreatment PTSD symptom severity as predictors of dropout and moderators of the alliance-dropout association. Clients were part of a larger randomized implementation trial, and either began CPT and dropped out (n = 38) or completed 12 sessions of CPT (n = 74). Results indicated early therapeutic alliance did not significantly predict treatment dropout, and age and PTSD severity were not significant predictors or moderators of the alliance-dropout association. Clinical implications of the findings are discussed.

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Supplemental Material for Latent Class Differences Explain Variability in PTSD Symptom Changes During Cognitive Processing Therapy for Veterans

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/a0030359.supp ◽

2013 ◽

Keyword(s):

Cognitive Processing ◽

Latent Class ◽

Ptsd Symptom ◽

Cognitive Processing Therapy ◽

Class Differences ◽

Symptom Changes

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Latent Difference Score Modeling to Examine Relationships Among PTSD Symptom Clusters During Cognitive Processing Therapy

PsycEXTRA Dataset ◽

10.1037/e533652013-046 ◽

2012 ◽

Author(s):

Michael Suvak ◽

Michael Treanor ◽

Karen Mitchell ◽

Denise Sloan ◽

Patricia Resick

Keyword(s):

Cognitive Processing ◽

Ptsd Symptom ◽

Symptom Clusters ◽

Difference Score ◽

Cognitive Processing Therapy ◽

Latent Difference Score Modeling ◽

Latent Difference Score

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Patterns and temporal precedence of symptom change during cognitive processing therapy for military sexual trauma-related posttraumatic stress disorder

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465819000183 ◽

2019 ◽

Vol 47 (5) ◽

pp. 541-547

Author(s):

Nicholas Holder ◽

Ryan Holliday ◽

Jessica Wiblin ◽

Alina Surís

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Cognitive Processing ◽

Sexual Trauma ◽

Stress Disorder ◽

Ptsd Symptom ◽

Cognitive Processing Therapy ◽

Military Sexual Trauma ◽

Ptsd Symptoms ◽

Symptom Criteria

AbstractBackground:Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD), including for veterans with military sexual trauma (MST)-related PTSD. Most CPT research to date has focused on pre- to post-treatment change in total PTSD symptoms; however, PTSD symptom criteria may not change equivalently over the course of treatment. For example, changes in re-experiencing symptoms have been shown to precede changes in other PTSD criteria during other PTSD treatments (i.e. virtual reality exposure therapy, venlafaxine ER). An improved understanding of the mechanism of change in PTSD symptoms during CPT may assist in optimizing treatment.Aims:The purpose of this study was to identify the pattern and temporal precedence of change in PTSD symptom criteria during and after CPT using cross-lagged panel analyses.Method:Data from veterans (n = 32) enrolled in a randomized clinical trial investigating the effectiveness of CPT for MST-related PTSD were utilized for this secondary analysis. Using hierarchical linear modelling, each symptom criterion was entered as a predictor of subsequent change in the other PTSD symptom criteria.Results:All symptom criteria followed a logarithmic pattern of change. Hyperarousal symptoms were found to both predict and temporally precede change in avoidance symptoms, but not re-experiencing symptoms. Re-experiencing and avoidance symptoms did not predict change in other PTSD symptom criteria.Conclusions:These findings provide initial support that targeting and reducing hyperarousal symptoms may be a key component of PTSD intervention with CPT. Additional research is needed to identify factors that predict change in PTSD-related re-experiencing symptoms.

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