Symposia
Trauma and Stressor Related Disorders and Disasters
Philip Held, Ph.D.
Assistant Professor
Rush
Chicago, Illinois
Dale Smith, PhD
Statistician
Rush University Medical Center
Chicago, Illinois
Jennifer Coleman, PhD
Assistant Professor
Rush University Medical Center
Chicago, Illinois
Brian Klassen, PhD
Assistant Professor
Rush University Medical Center
Chicago, Illinois
In intensive treatment programs (ITPs) evidence-based psychotherapies are delivered daily over the course of 1-3 weeks. ITPs have been shown to be successful at reducing posttraumatic stress disorder (PTSD) and depression symptoms in veterans. Although the role of the working alliance in the context of traditional psychotherapy is relatively well understood, its role in ITPs is largely unexplored. In this presentation we will present data from a study examining veteran-rated working alliance with their individual Cognitive Processing Therapy (CPT) provider as a predictor of changes in PTSD and depression symptoms as well as negative posttrauma cognitions in two unique ITP formats. Data were collected from 128 veterans who completed a 2-week ITP, involving 2x individual CPT/day, as well as 73 veterans who completed a 3-week ITP, involving 1x group CPT/day and 1x individual CPT/day. Both ITPs included adjunctive wellness, skills, and psychoeducation services in addition to CPT. Linear mixed effects models were used to determine whether changes in working alliance predicted changes in PTSD and depression symptoms. Stronger veteran-reported working alliance with their individual CPT therapist, most notably agreement on tasks, predicted significant reductions in both the 2-week and 3-week programs in PTSD (ps = .012 and .002, respectively) and depression symptoms (ps = .009 and .007, respectively) and negative posttrauma cognitions (ps = .009 and .016, respectively). These results highlight the importance of veterans’ perceived working alliance with their individual treatment therapists in ITPs. Results suggest that a strong working alliance that is meaningful for treatment outcomes can be developed quickly despite the brevity of this intensive treatment format. The presentation will conclude with suggestions for future research, such as examining ways to facilitate the development of a strong working alliance prior to or as early as possible in ITPs.