Therapeutic alliance, negative mood regulation, and treatment outcome in child abuse-related posttraumatic stress disorder
Abstract
This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic memories. Hierarchical regression analyses indicated the strength of the therapeutic alliance established early in treatment reliably predicted improvement in PTSD symptoms at posttreatment. Furthermore, this relationship was mediated by participants' improved capacity to regulate negative mood states in the context of Phase 2 exposure therapy. In the treatment of childhood abuse-related PTSD, the therapeutic alliance and the mediating influence of emotion regulation capacity appear to have significant roles in successful outcome.
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The capacity to establish and navigate an effective working alliance is essential to maximize the benefits of behavioral intervention and is particularly integral to the success of PE.
“The capacity to establish and navigate an effective working alliance is essential to maximize the benefits of behavioral intervention (Horvath and Luborsky, 1993), and particularly integral to the success of PE (Cloitre et al., 2004; McLaughlin et al., 2014).”
From Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: a randomized, placebo-controlled pilot trial (2018) · cites this paper as Cloitre et al., 2004
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- Authors
- Cloitre, M., Chase Stovall-McClough, K., Miranda, R., & Chemtob, C. M.
- Affiliations
- New York University (US)
- Icahn School of Medicine at Mount Sinai (US)
- ORCID
- Miranda, Regina
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2004-06
- Volume
- 72
- Issue
- 3
- Pages
- 411-416
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W1976275501
- Cited by
- 333
- References
- 45
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 12 · 2023: 9 · 2022: 28 · 2021: 14 · 2020: 16 · 2019: 11 · 2018: 12 · 2017: 23 · 2016: 25 · 2015: 43 · 2014: 15 · 2013: 17 · 2012: 10
- FWCI
- 11.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r21mh057883-02)
- National Institute of Mental Health (MH 62347, MH 57883, R01MH062347)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- therapeutic relationship, negative mood regulation, emotion regulation, childhood abuse, post-traumatic stress disorder, treatment outcomes, two-phase treatment, trauma-focused psychotherapy, mediation
- MeSH terms
- Adult, Affect, Child, Child Abuse, Female, Humans, Male, Patient Care Team, Psychotherapy, Stress Disorders, Post-Traumatic
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