Send to

Choose Destination
See comment in PubMed Commons below
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.



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


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.


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.


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).


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


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

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Loading ...
    Support Center