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Does the working alliance mediate the effect of routine outcome monitoring (ROM) and alliance feedback on psychotherapy outcomes? A secondary analysis from a randomized clinical trial

Brattland, Heidi; Koksvik, John Morten; Burkeland, Olav; Kløckner, Christian; Lara Cabrera, Mariela Loreto; Miller, Scott D.; Wampold, Bruce E.; Ryum, Truls; Iversen, Valentina Cabral
Journal article, Peer reviewed
Published version
Åpne
Brattland (Låst)
Permanent lenke
http://hdl.handle.net/11250/2633459
Utgivelsesdato
2019
Metadata
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  • Institutt for psykisk helse [753]
  • Institutt for psykologi [1965]
  • Publikasjoner fra CRIStin - NTNU [26591]
  • Publikasjoner fra Cristin - St. Olavs hospital [771]
  • St. Olavs hospital [1309]
Originalversjon
Journal of Counseling Psychology. 2019, 66 (2), 234-246.   10.1037/cou0000320
Sammendrag
Little is known about the mechanisms through which routine outcome monitoring (ROM) influences psychotherapy outcomes. In this secondary analysis of data from a randomized clinical trial (Brattland et al., 2018), we investigated whether the working alliance mediated the effect of the Partners for Change Outcome Monitoring System (PCOMS), a ROM system that provides session-by-session feedback on clients’ well-being and the alliance. Adult individuals (N = 170) referred for hospital-based outpatient mental health treatment were randomized to individual psychotherapy either with the PCOMS ROM system, or without (treatment as usual [TAU]). Treatment was provided by the same therapists (N = 20) in both conditions. A multilevel mediation model was developed to test if there was a significant indirect effect of ROM on client impairment at posttreatment through the alliance at 2 months’ treatment controlled for first-session alliance. Alliance ratings increased more from session 1 to 2 months’ treatment in the ROM than TAU condition, and alliance increase was associated with less posttreatment impairment. A significant indirect effect of ROM on treatment outcomes through alliance increase (p = .043) explained an estimated 23.0% of the effect of ROM on outcomes. The results were consistent with a theory of the alliance as one mechanism through which ROM works.
Utgiver
American Psychological Association
Tidsskrift
Journal of Counseling Psychology

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