Is adherence to dialectic behaviour therapy for post-traumatic stress disorder (PTSD) and cognitive processing therapy related to treatment outcome in PTSD after childhood abuse?

Publisher: Taylor & Francis Country of Publication: United States NLM ID: 101559025 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2000-8066 (Electronic) Linking ISSN: 20008066 NLM ISO Abbreviation: Eur J Psychotraumatol Subsets: MEDLINE

Publication: 2016- : Philadelphia, PA : Taylor & Francis
Original Publication: [Järfälla] : [Amsterdam] : Co-action Pub. ; The European Society for Traumatic Stress Studies, [2010]-

Stress Disorders, Post-Traumatic*/psychology ; Dialectical Behavior Therapy* ; Child Abuse*/therapy ; Child Abuse*/psychology ; Cognitive Behavioral Therapy*/methods; Humans ; Female ; Child ; Treatment Outcome

Background: Literature on the association between therapist adherence and treatment success in the treatment of post-traumatic stress disorder (PTSD) is scarce, and the results are mixed. Objective: To examine the relationship between therapist adherence to dialectical behaviour therapy for PTSD (DBT-PTSD) and cognitive processing therapy (CPT) on treatment outcome in women with PTSD and emotion regulation difficulties after interpersonal childhood abuse. Method: Videotaped therapy sessions from 160 female participants of a large randomized controlled trial [Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse. JAMA Psychiatry , 77 (12), 1235. jamapsychiatry.2020.2148] were rated. Adherence to CPT and DBT-PTSD was assessed using two specifically developed rating scales. Results: Higher therapist adherence was associated with a greater reduction of clinician-rated PTSD symptom severity. This effect was more pronounced in the CPT group than in the DBT-PTSD group. Adherence was also related to a greater reduction of self-rated PTSD symptoms, borderline symptoms, and dissociation intensity. Conclusion: Our results indicate that higher therapist adherence can lead to better treatment outcomes in PTSD treatments, especially in CPT.

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Keywords: PTSD治疗完整性; Post-traumatic stress disorder; treatment integrity; Trastorno de estrés postraumático; adherencia al tratamiento; cognitive processing therapy; dialectical behaviour therapy for PTSD; fidelidad al tratamiento; integridad del tratamiento; terapia de procesamiento cognitivo; terapia dialéctica conductual para TEPT; therapeutic adherence; treatment fidelity; 创伤后应激障碍; 治疗依从性; 治疗保真度; 认知加工疗法; 辩证行为疗法
Local Abstract: [plain-language-summary] Higher therapist adherence to cognitive processing therapy was associated with higher treatment gains in women with post-traumatic stress disorder (PTSD) after childhood abuse.Adherence was related to higher reductions in symptom severity of PTSD, borderline symptoms, and dissociation intensity.Adherence to dialectical behaviour therapy for PTSD did not show a strong association with treatment outcome.

DRKS DRKS00006095

Date Created: 20231020 Date Completed: 20231023 Latest Revision: 20231025

20240628

PMC10591525

10.1080/20008066.2023.2260293

37860858