Interpersonal factors in relationship to therapy outcome and therapeutic alliance in a cohort of multiple sclerosis patients.

摘要

The relationship among interpersonal problems, therapeutic alliance, post-treatment levels of depression, and disease-related variables was studied in 46 clients diagnosed with multiple sclerosis (MS) and major depressive disorder (MDD). Participants were administered the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), the Hamilton Rating Scale for Depression (HRSD; Hamilton, 1960; Whisman et al., 1989), the Inventory of Interpersonal Problems-Circumplex (IIP-C; Alden, Wiggins, & Pincus, 1990), the Working Alliance Inventory, which was also completed by the therapists (WAI-C or -T; Horvath & Greenberg, 1989), and numerous disease-related measures. Participants completed one of 2 16-week treatments for depression: individual cognitive behavioral therapy (CBT) or supportive-expressive group therapy (SEG). The key finding of the study was that the WAI-C mediated the relationship between the IIP-C and the post treatment BDI. More specifically, the WAI-C mediated the relationship between a single scale of the IIP-C, dominant/controlling, and post-treatment BDI scores. However, these findings were not replicated with either the HRSD or WAI-T. These inconsistencies are discussed. None of the MS disease-related variables impacted depression outcome. These findings suggest that regular assessment of the client's understanding of the therapeutic alliance could aid in the further reduction of depressive symptomatology.