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Cited by 71Psychotherapy Techniques and ApplicationsSchizophrenia research and treatmentPsychoanalysis and Psychopathology Research

The Therapeutic Relationship in CBT for Psychosis: Client, Therapist and Therapy Factors

Evans-Jones, Catherine, Peters, Emmanuelle, Barker, Chris·2009·Behavioural and Cognitive Psychotherapy
DOI 10.1017/s1352465809990269
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Abstract

Background: This study investigated which factors are associated with the therapeutic relationship in Cognitive-Behavioural Therapy for psychosis (CBTp). Method: Measures were taken between sessions two to nine in 24 therapist-client dyads. Clients and therapists completed the Working Alliance Inventory and measures of client (gender, age, ethnicity, positive and negative symptoms of psychosis, length of illness, admissions, social contacts, employment, cognitive insight, reaction to hypothetical contradiction), therapist (empathy, expertness, attractiveness, trustworthiness, number of years qualified and previous CBTp clients seen, confidence in CBTp), and therapy (number of sessions and CBTp interventions carried out, presentation of a formulation) factors. Results: On average, clients and therapists rated the therapeutic relationship as good, with clients giving higher ratings. None of the client variables was related significantly to the quality of the relationship. However, a number of therapist and therapy factors were linked to a better therapeutic relationship, namely clients' ratings of therapist empathy, expertness, attractiveness, and trustworthiness and, at trend level, a greater number of sessions and of CBTp interventions, and the presentation of a formulation. Conclusions: These results suggest that therapists are able to develop a good therapeutic relationship with clients with psychosis, regardless of the severity of the psychosis and the confidence and experience of the therapist, although non-significant findings need interpreting with caution due to the lack of a full range of therapeutic alliances. The findings also suggest that the basic tenets of CBTp, such as empathy and collaborative goals, may be important factors for the development of the therapeutic relationship.

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Authors
Evans-Jones, C., Peters, E., & Barker, C.
Affiliations
  • King's College London (GB)
  • University College London (GB)
Corresponding author
Peters, Emmanuelle
ORCID
Venue
Behavioural and Cognitive Psychotherapy
Publisher
Cambridge University Press (CUP)
Published
2009-09-04
Volume
37
Issue
5
Pages
527-540
ISSN
  • 1352-4658 (ISSN-L)
  • 1469-1833
DOI
10.1017/s1352465809990269
OpenAlex
W2134789087
Cited by
71
References
56
Citations by year
2026: 3 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 8 · 2019: 4 · 2018: 5 · 2017: 4 · 2016: 6 · 2015: 4 · 2014: 8 · 2013: 7 · 2012: 4
FWCI
3.88
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Behavioural and Cognitive Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
therapeutic relationship, cognitive behavioural therapy for psychosis, therapist empathy, therapist expertise, formulation, psychotic symptoms
MeSH terms
Adult, Consumer Behavior, Cross-Sectional Studies, Empathy, Female, Humans, Male, Middle Aged, Professional Competence, Professional-Patient Relations, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenia, Paranoid, Schizophrenic Psychology, Cognitive Behavioral Therapy, Trust, Young Adult

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