Citation

Steil R, Weiss J, Müller-Engelmann M, Dittmann C, Priebe K, Kleindienst N, Fydrich T, Stangier U. Eur. J. Psychotraumatol. 2023; 14(2): e2260293.

Copyright

(Copyright © 2023, The Author(s), Publisher Co-action Publishing)

DOI

10.1080/20008066.2023.2260293

PMID

37860858

PMCID

PMC10591525

Abstract

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.

Language: en

Keywords

adherencia al tratamiento; Child; Child Abuse; Cognitive Behavioral Therapy; cognitive processing therapy; Dialectical Behavior Therapy; dialectical behaviour therapy for PTSD; Female; fidelidad al tratamiento; Humans; integridad del tratamiento; Post-traumatic stress disorder; treatment integrity; PTSD治疗完整性; Stress Disorders, Post-Traumatic; terapia de procesamiento cognitivo; terapia dialéctica conductual para TEPT; therapeutic adherence; Trastorno de estrés postraumático; treatment fidelity; Treatment Outcome; 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