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Randomized Controlled Trial
. 2013 Dec;46(8):783-9.
doi: 10.1002/eat.22187. Epub 2013 Sep 6.

Therapeutic alliance in two treatments for adults with severe and enduring anorexia nervosa

Colleen Stiles-Shields  1 , Stephen Touyz, Phillipa Hay, Hubert Lacey, Ross D Crosby, Elizabeth Rieger, Bryony Bamford, Daniel Le Grange
Affiliations
Free article
Randomized Controlled Trial

Therapeutic alliance in two treatments for adults with severe and enduring anorexia nervosa

Colleen Stiles-Shields et al. Int J Eat Disord. 2013 Dec.
Free article

Abstract

Objective: The aim of this study was to investigate the strength and role of therapeutic alliance in a trial comparing Cognitive Behavioral Therapy for anorexia nervosa (CBT-AN) and Specialist Supportive Clinical Management for the treatment of severe and enduring AN (SE-AN).

Method: Participants were 63 adult females with SE-AN presenting to an outpatient, multisite randomized controlled trial conducted at two clinical sites. Participants completed measures assessing their perception of the quality of the therapeutic relationship, eating disorder (ED) symptomatology, and depressive symptomatology.

Results: Beyond the effect of early treatment change and treatment assignment, early therapeutic alliance was a significant predictor of Restraint and Shape Concern at follow-up (ps < .02). Late therapeutic alliance was a significant predictor of weight change, depressive symptomatology, and ED symptomatology at end of treatment and follow-up (ps < .008), with the exception of Shape Concern at follow-up (p = .07).

Discussion: The results suggest that therapeutic alliance can be effectively established in the treatment of SE-AN and may be relevant for treatment response, particularly in late treatment, on some aspects of ED and depressive symptomatology.

Keywords: anorexia nervosa; cognitive behavioral therapy; specialist supportive clinical management; therapeutic alliance.

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