Trial reportJournal of traumatic stress2021
The Effect of Therapeutic Alliance on Dropout in Cognitive Processing Therapy for Posttraumatic Stress Disorder.
Trial report in Journal of traumatic stress, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clients' experiences of psychotherapeutic interventions addressing trauma.Psychology and psychotherapy · 2025Pooled it
- The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis.Frontiers in psychiatry · 2022Pooled it
- Unfinished business: A grounded theory analysis of change among individuals classified as numerical non-responders to psychodynamic psychotherapy for post-traumatic stress disorder related to childhood maltreatment.Psychology and psychotherapy · 2026Trial
- The Role of the Therapeutic Alliance in Dropout in Cognitive Processing Therapy for Posttraumatic Stress Disorder.Behavior therapy · 2026Trial
- Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members.Journal of traumatic stress · 2023Trial
- Why was the treatment discontinued? Reasons for attrition in evidence-based trauma-focused treatments.European journal of psychotraumatology · 2025Article
- Who defines improvement? Patients' global reports of improvement compared to standardized measures of improvement in cognitive processing therapy for posttraumatic stress disorder.Journal of anxiety disorders · 2025Article
- Treatment-related beliefs and reactions among trauma-focused therapy completers and discontinuers: A qualitative examination.Psychological services · 2024Article
- Rates and reasons for veteran mental health service utilization following completion of evidence-based trauma-focused treatment for PTSD.Psychological services · 2024Article
- Rethinking treatment failures. Research on a group of Italian psychotherapists.Frontiers in psychology · 2024Article
- Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review.Current neuropharmacology · 2024Review
- Cognitive Orientation to daily Occupational Performance (CO-OP) for mood, anxiety, and adjustment disorders: a pilot study.Frontiers in psychiatry · 2024Article
- History of Sexual Assault as a Predictor of Response to a Self-Guided Online Program for Sexual Desire and Arousal Difficulties in Women.Archives of sexual behavior · 2023Article
- Leveraging observational data to identify in-session patient and therapist predictors of cognitive processing therapy response and completion.Journal of traumatic stress · 2023Article
- Building strong therapeutic relationships quickly: The effect of the perceived working alliance on veterans' intensive PTSD treatment outcomes.Psychotherapy (Chicago, Ill.) · 2022Article
- A Glimpse into the "Black Box": Which Elements of Consultation in an EBP are Associated with Client Symptom Change and Therapist Fidelity?Implementation research and practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
A substantial number of individuals who undergo cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) drop out before receiving a full course of treatment. Therapeutic alliance, defined as the working relationship between the therapist and client, is a dynamic process within therapy that may change over time. Research suggests that therapeutic alliance is associated with dropout in various treatments. However, no studies have yet examined the association between therapeutic alliance and dropout in CPT, and few studies have examined therapeutic alliance longitudinally over the course of treatment. Examining alliance in CPT through different methods may increase clinicians' understanding of how to tailor interventions to prevent treatment dropout. The present study examined the association between therapeutic alliance and treatment dropout among 169 participants in a randomized implementation effectiveness trial. In total, 33.1% of clients dropped out over the course of CPT, and nearly half of these individuals dropped out during the first six sessions. Continuous-time survival analysis results indicated that mean ratings of alliance significantly predicted treatment dropout, Wald χ
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Registered trials
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.