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Psychother Res. 2016;26(3):365-76. doi: 10.1080/10503307.2015.1006156. Epub 2015 Feb 11.

Effects of religious vs. standard cognitive behavioral therapy on therapeutic alliance: A randomized clinical trial.

Author information

  • 1a Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA.
  • 2b School of Medicine , University of Maryland , Baltimore , MD , USA.
  • 3c Department of Research , Glendale Adventist Medical Center , Glendale , CA , USA.
  • 4d Department of Psychology and Neuroscience , Duke University Medical Center , Durham , NC , USA.
  • 5e Epidemiology, Biostatistics, and Population Medicine, School of Public Health , Loma Linda University , Loma Linda , CA , USA.
  • 6f Department of Medicine , Duke University Medical Center , Durham , NC , USA.
  • 7g Division of Psychiatry, Faculty of Brain Sciences , University College London , London , UK.

Abstract

BACKGROUND:

Treatments that integrate religious clients' beliefs into therapy may enhance the therapeutic alliance (TA) in religious clients.

OBJECTIVE:

Compare the effects of religiously integrated cognitive behavioral therapy (RCBT) and standard CBT (SCBT) on TA in adults with major depression and chronic medical illness.

METHOD:

Multi-site randomized controlled trial in 132 participants, of whom 108 (SCBT = 53, RCBT = 55) completed the Revised Helping Alliance Questionnaire (HAQ-II) at 4, 8, and 12 weeks. Trajectory of change in scores over time was compared between groups.

RESULTS:

HAQ-II score at 4 weeks predicted a decline in depressive symptoms over time independent of treatment group (B = -0.06, SE = 0.02, p = 0.002, n = 108). There was a marginally significant difference in HAQ-II scores at 4 weeks that favored RCBT (p = 0.076); however, the mixed effects model indicated a significant group by time interaction that favored the SCBT group (B = 1.84, SE = 0.90, degrees of freedom = 181, t = 2.04, p = 0.043, d = 0.30).

CONCLUSIONS:

While RCBT produces a marginally greater improvement in TA initially compared with SCBT, SCBT soon catches up.

KEYWORDS:

CBT; chronic illness; major depression; psychotherapy; religious; spiritual; therapeutic alliance

PMID:
25669236
DOI:
10.1080/10503307.2015.1006156
[PubMed - indexed for MEDLINE]
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