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ONLINE WORKING ALLIANCE PREDICTS TREATMENT OUTCOME FOR POSTTRAUMATIC STRESS SYMPTOMS IN A RAB WAR‐TRAUMATIZED PATIENTS
Author(s) -
Wagner Birgit,
Brand Janine,
Schulz Wassima,
Knaevelsrud Christine
Publication year - 2012
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.21962
Subject(s) - psychological intervention , clinical psychology , psychology , intervention (counseling) , posttraumatic stress , alliance , cognitive behavioral therapy , psychiatry , medicine , cognition , political science , law
Background Previous studies have shown that I nternet‐based interventions for posttraumatic stress disorder are feasible. However, little is known about how therapeutic process factors impact online interventions in war and conflict regions. Objective This study aims to assess the quality of the working alliance at midtreatment and posttreatment and its relationship with therapy outcome in an I nternet‐based cognitive‐behavioral intervention for A rabic‐speaking traumatized patients. Methods A trial was conducted from J anuary 2009 to A ugust 2011 with patients recruited specifically in I raq. Fifty‐five participants with posttraumatic stress symptoms completed the W orking A lliance I nventory ( WAI ) after at least session 4. Participants’ mean age was 27.7 years ( SD = 6.9); 78% of participants were females. Participants received two weekly 45‐min I nternet‐based cognitive‐behavioral interventions over a 5‐week period. The main outcome measures were the P osttraumatic D iagnostic S cale ( PDS ) and the WAI . Results High ratings of the therapeutic alliance were obtained early in treatment, and results remained stable from sessions 4 to 10, indicating that it was possible to establish a positive and stable online therapeutic relationship. The working alliance at both assessment points predicted treatment outcome for posttraumatic stress symptoms. Conclusions Despite the instability of the settings and patients’ ongoing exposure to human right violations through war and dictatorships, it was possible to establish a stable online therapeutic relationship.