Therapeutic Alliance Tensions and Repair in Psychotherapy Practices

NCT03453957 | Completed

• 1 other identifier: 363733
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 2

Brief Summary

This study evaluates a professional development program intended to improve the relationship or alliance between therapists and patients/clients who are receiving psychotherapy in the community. Half of the participating therapists will receive training to detect and improve alliance with new patients while half will not. The professional development training is expected to improve therapists effectiveness in identifying and correcting alliance tensions which will, in turn, improve therapeutic outcomes for patients/clients.

Conditions

Psychotherapy; Therapeutic Alliance

Keywords

Practice based research

Outcome Measures

Primary Outcomes (1)

• Mean tension resolution rating scale

  The Rupture Resolution Rating System (3RS) is an observer-based measure to identify alliance tensions and resolution processes. Independent blind reliable trained judges will rate video recordings of 6 psychotherapy session recorded with participating clients. A mean tension score will be assigned per client which will be the average of the 6 session scores. score ranges from 1 (withdrawal/confrontation rupture(s) did not occur; not significant for the alliance) to 5 (withdrawal/confrontation rupture(s) occurred; significant for the alliance).

  6 therapy sessions over 6 weeks up to 6 months depending on the frequency of therapy

Secondary Outcomes (2)

• Generalized Anxiety Disorder 7-item scale (GAD-7) change from baseline

  baseline and end of 6 therapy sessions, 6 weeks to 6 months depending on the frequency of therapy

• Patient Health Questionnaire 9-item scale (PHQ-9) change from baseline

  baseline and end of 6 therapy sessions, 6 weeks to 6 months depending on the frequency of therapy

Study Arms (2)

Professional Development Program

EXPERIMENTAL

Therapists who participate in workshops and consultation sessions with study trainers during study-related therapy sessions and their participating patients/clients.

Other: Professional development program

Control

NO INTERVENTION

Therapists who did not participate in workshops and consultations sessions while engaging in study-related therapy sessions and their participating patients/clients.

Interventions

Professional development program OTHER

Professional development program consists of training including workshops and consultation sessions to enhance therapists ability to detect and repair alliance ruptures in active community based psychotherapy.

Professional Development Program

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• regulated health professional
• in good standing with a Canadian provincial regulatory college
• scope of practice includes psychotherapy
• ability to add 3 or more new, English speaking clients to caseload over 6 to 9 months
• ability to obtain timely permission to conduct research from therapist's employing institution or health group when applicable

You may not qualify if:

• none
• Patient/Client
• years of age or older
• will participate in psychotherapy sessions in English
• will see the study-affiliated therapist for a minimum of 6 sessions in the next 6 months
• already seeing another therapist
• diagnosed with a neurocognitive disorder
• diagnosed with a psychotic disorder
• expressed suicidal behaviour in the past six months as assessed by their participating therapist

Sponsors & Collaborators

• Canadian Institutes of Health Research (CIHR): collaborator
• University of Ottawa: lead

Study Sites (2)

University of Ottawa

Ottawa, Ontario, K1N 6N5, Canada

Location

Mt. Sinai Hospital

Toronto, Ontario, M5G 1X5, Canada

Location

Related Links

• PPRNet website including study-related information and publications

Study Officials

• Giorgio Tasca, Ph.D.

  University of Ottawa

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participating therapists will be aware of their group (Asynchronous virtual training, synchronous virtual workshop training, no training control); however, their participating patient/clients will not know which experimental group their therapists belongs to.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: This will be a 2-arm, parallel, prospective, single-blind cluster RCT with 1-1 allocation comparing: (a) therapists who receive the professional development intervention to identify and repair alliance tensions at the study outset versus (b) therapists who receive the intervention after participation is complete (no training control). Therapists will be randomized to study condition and patients will be clustered within therapists. Randomization will control for: (a) the effect of therapist variables (age, gender, theoretical orientation, experience, differing initial skill level) on competence, therapeutic alliance, or patient outcomes; (b) potential biases caused by pre-treatment patient variables (symptom severity, co-morbidity, chronicity, psychoactive medications); and (c) treatment or study factors (e.g. frequency of sessions, time to complete the study sessions, treatment received after the study sessions). Patients will be blind to therapist study arm allocation.

Study Record Dates

• First Submitted: February 16, 2018
• First Posted: March 5, 2018
• Study Start: February 1, 2018
• Primary Completion: May 14, 2021
• Study Completion: August 14, 2021
• Last Updated: May 1, 2026

Record last verified: 2022-06

Data Sharing

• IPD Sharing: Will not share

Locations

CA (2)