Therapeutic Alliance and Treatment Expectations: Predicting Outcomes in Exposure Treatments for Specific Phobia

Areas, Malenka; Babl, Anna Margarete; Fernández-Álvarez, Javier; Roussos, Andrés; Botella, Christina; García-Palacios, Azucena; Baños, Rosa; Quero, Soledad; Breton, Juana María; Gómez Penedo, Juan Martín (2023). Therapeutic Alliance and Treatment Expectations: Predicting Outcomes in Exposure Treatments for Specific Phobia. Cognitive therapy and research, 47(2), pp. 222-231. Springer 10.1007/s10608-022-10343-8

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Background
Exposure-based treatments have demonstrated some of the largest effect sizes in the treatment of specific phobias (SP). There are different ways of delivering exposure such as Augmented Reality Exposure which has become an interesting alternative to In Vivo Exposure for treating SP. The present study aimed to investigate the therapeutic alliance and treatment expectations as possible predictors of treatment outcomes in these two exposure treatment conditions.

Methods
Participants were 63 adults who met diagnostic criteria for the diagnosis of a SP of cockroaches or spiders (animal subtype). Patients were randomized to receive a one-session treatment of either In Vivo Exposure (N = 31) or Augmented Reality Exposure (N = 32). The assessment protocol included diagnostic, as well as primary-, and secondary outcome measures. Materials included the Behavioral Avoidance Test for measuring symptoms and outcomes, the Expectations and Satisfaction Questionnaire, and the Working Alliance Inventory. We ran multilevel analyses for the study of predictors controlling for the treatment effect conditions.

Results
Results showed a significant effect of expectations on treatment outcomes (specifically avoidance and beliefs scores). The therapeutic alliance did not have a significant effect on treatment outcome. Patients reduced their symptoms of phobia.

Conclusion
These results empirically support treatment expectations as a relevant predictor of change in exposure treatments for SP.

Item Type:

Journal Article (Original Article)

Division/Institute:

07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
07 Faculty of Human Sciences > Institute of Psychology

UniBE Contributor:

Babl, Anna Margarete, Fernandez-Alvarez, Javier, Gomez Penedo, Juan Martin

Subjects:

600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology

ISSN:

0147-5916

Publisher:

Springer

Language:

English

Submitter:

Alina Kneubühler

Date Deposited:

31 Mar 2023 11:26

Last Modified:

02 Apr 2023 02:14

Publisher DOI:

10.1007/s10608-022-10343-8

BORIS DOI:

10.48350/180473

URI:

https://boris.unibe.ch/id/eprint/180473

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