TY  - JOUR
A1  - Steil, Regina
A1  - Weiß, Judith
A1  - Renneberg, Babette
A1  - Gutermann, Jana
A1  - Rosner, Rita
T1  - Effect of therapeutic competence, adherence, and alliance on treatment outcome in youth with PTSD treated with developmentally adapted cognitive processing therapy
T2  - Child Abuse & Neglect
N2  - Background: Developmentally adapted cognitive processing therapy (D-CPT) is an effective treatment for posttraumatic stress disorder (PTSD) in adolescents and young adults. It is unclear if therapeutic adherence and competence in D-CPT are associated with higher PTSD treatment gains.
Objective: To assess if higher therapeutic adherence and competence in D-CPT are associated with higher symptom reduction of PTSD in adolescents and young adults, while controlling for therapeutic alliance.
Participants and setting: Participants were 38 patients (aged 14–21 years; M = 17.61 years, SD = 2.42 years) of a multicenter randomized controlled trial in which the efficacy of D-CPT was compared to a waitlist with treatment advice.
Methods: Videotaped therapy sessions were rated using validated ratings scales to assess adherence and competence. Therapeutic alliance was assessed via weekly patient ratings. We used hierarchical linear modelling to assess the relationship of adherence and competence on PTSD symptoms being measured by both clinician and patient while controlling for alliance.
Results: Neither adherence nor competence were related to treatment outcomes in clinician or patient rated PTSD symptom severity. Higher alliance was associated with a lower symptom severity at 12 months posttreatment in both clinician and patient rated PTSD symptoms.
Conclusions: In this study of young adults with PTSD, who were treated with D-CPT by well-trained therapists, therapeutic adherence and competence were not related to treatment outcome. This might be explained by a lack of range in therapist adherence and competence. Therapeutic alliance had a positive effect on PTSD symptom severity.
KW  - Posttraumatic stress disorder
KW  - Therapeutic adherence
KW  - Therapeutic competence
KW  - Developmentally adapted cognitive processing therapy
KW  - Child and adolescent psychotherapy
Y1  - 2023
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78991
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-789910
SN  - 0145-2134
VL  - 141
IS  - 106221
PB  - Elsevier
CY  - Amsterdam
ER  -