Evidence map›Paper›PMID 26164110›Full record

Trial reportJournal of behavior therapy and experimental psychiatry2016

The therapeutic alliance and therapist adherence as predictors of dropout from cognitive therapy for depression when combined with antidepressant medication.

Andrew A Cooper, Daniel R Strunk, Elizabeth T Ryan, Robert J DeRubeis, Steven D Hollon, Robert Gallop

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of behavior therapy and experimental psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Andrew A CooperThe Ohio State University, USA.
Daniel R StrunkThe Ohio State University, USA. Electronic address: strunk.20@osu.edu.
Elizabeth T RyanThe Ohio State University, USA.
Robert J DeRubeisUniversity of Pennsylvania, USA.
Steven D HollonVanderbilt University, USA.
Robert GallopWest Chester University, USA.
The Ohio State University · USCalifornia University of Pennsylvania · USVanderbilt University · USWest Chester University · US

Funding

PREVENTION OF RECURRENCE IN DEPRESSION WITH DRUGS AND CTR01MH060998 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI DERUBEIS, ROBERT J · 2002 to 2011
$6.5M
Prevention of Recurrence in Depression with Drugs and CTR01MH060713 · NIMH · VANDERBILT UNIVERSITY · PI HOLLON, STEVEN DENNIS · 2002 to 2011
$5.2M
Prevention of Recurrence in Depression with Drugs and CTR01MH060768 · NIMH · RUSH UNIVERSITY MEDICAL CENTER · PI ZAJECKA, JOHN M · 2002 to 2011
$5.1M
Prevention of Recurrence in Depression with Drugs and CTK02MH001697 · NIMH · VANDERBILT UNIVERSITY · PI HOLLON, STEVEN DENNIS · 2000 to 2009
$1.2M
NIMH NIH HHS K02 MH001697NIMH NIH HHS MH01697NIMH NIH HHS MH060768NIMH NIH HHS MH60713NIMH NIH HHS MH60998NIMH NIH HHS R01 MH060713NIMH NIH HHS R01 MH060768NIMH NIH HHS R01 MH060998
6 · The paper itself

Abstract

backgroundPrevious psychotherapy research has examined the therapeutic alliance and therapist adherence as correlates or predictors of symptom change. While some initial evidence suggests the alliance is associated with risk of dropout in cognitive behavioral treatment for depression, evidence of such relations has been limited to date. We examined the relation of these psychotherapy process variables and dropout in the context of cognitive therapy for depression when provided in combination with pharmacotherapy.

methodsPatients were randomized to the CT plus pharmacotherapy condition of a clinical trial for chronic or recurrent depression. Consistent with the spirit of personalized medicine, patients were treated until they met remission and recovery criteria (or reached the maximum allowable time in the study). In a sample of 176 patients, we examined observer-rated alliance and therapist adherence in the first three CT sessions as potential predictors of treatment dropout.

resultsThe therapeutic alliance and one facet of therapist adherence (i.e., Behavioral Methods/Homework) predicted reduced odds of dropout. Therapist use of Negotiating/Structuring predicted greater likelihood of dropout, but only when other variables were included in the model. LIMITATIONS: Process ratings were not available for concurrent pharmacotherapy sessions. A minority of patients did not have session recordings available.

conclusionsResults are consistent with the possibility that the therapeutic alliance and therapists' focus on homework and behavioral methods promote treatment retention in combined treatment for depression.

Indexed as

Patient CompliancePatient DropoutsProfessional-Patient RelationsAdultAntidepressive AgentsCognitive Behavioral TherapyCombined Modality TherapyFemaleHumansMajor Depressive DisorderMaleMiddle AgedTreatment OutcomeAntidepressive AgentsAdherenceAllianceCognitive therapyDepressionDropout

Identifiers

PMID26164110
PMCPMC4679463
OpenAlexW827461714

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.