Effects of religious vs. standard cognitive behavioral therapy on therapeutic alliance: A randomized clinical trial

• Published in: Psychotherapy research 2016-05, Vol.26 (3), p.365-376
• Main Authors: Koenig, Harold G., Pearce, Michelle, Nelson, Bruce, Shaw, Sally, Robins, Clive, Daher, Noha, Cohen, Harvey Jay, King, Michael B.
• Format: Article
• Language: English
• Subjects: Adult; Aged; alleanza terapeutica; CBT; Chronic Disease - psychology; chronic illness; chronische Erkrankungen; Clinical trials; Cognitive Therapy - methods; depressione maggiore; Depressive Disorder, Major - therapy; Female; Humans; KVT; major depression; malattia cronica; Male; Middle Aged; Outcome and Process Assessment (Health Care); Professional-Patient Relations; psicoterapia; Psychotherapie; Psychotherapy; Religion; Religion and Psychology; religioso; religious; religiös; spiritual; spirituale; spirituell; therapeutic alliance; Therapiebeziehung; Therapist patient relationships; 宗教的; 心理治療; 慢性疾病; 治療同盟; 認知行為治療; 重度憂鬱; 靈性的
• ISSN: 1050-3307; 1468-4381
• DOI: 10.1080/10503307.2015.1006156

Background: Treatments that integrate religious clients' beliefs into therapy may enhance the therapeutic alliance (TA) in religious clients. Objective: Compare the effects of religiously integrated cognitive behavioral therapy (RCBT) and standard CBT (SCBT) on TA in adults with major depression and chronic medical illness. Method: Multi-site randomized controlled trial in 132 participants, of whom 108 (SCBT = 53, RCBT = 55) completed the Revised Helping Alliance Questionnaire (HAQ-II) at 4, 8, and 12 weeks. Trajectory of change in scores over time was compared between groups. Results: HAQ-II score at 4 weeks predicted a decline in depressive symptoms over time independent of treatment group (B = −0.06, SE = 0.02, p = 0.002, n = 108). There was a marginally significant difference in HAQ-II scores at 4 weeks that favored RCBT (p = 0.076); however, the mixed effects model indicated a significant group by time interaction that favored the SCBT group (B = 1.84, SE = 0.90, degrees of freedom = 181, t = 2.04, p = 0.043, d = 0.30). Conclusions: While RCBT produces a marginally greater improvement in TA initially compared with SCBT, SCBT soon catches up.