Patient expectations and therapeutic alliance as predictors of outcome in group cognitive-behavioral therapy for Insomnia

Michael J. Constantino, Rachel Manber, Jason Ong, Tracy F. Kuo, Jennifer S. Huang, Bruce A. Arnow

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Despite growing evidence for the efficacy of cognitive-behavioral therapy for insomnia (CBT-I), few data exist on the relation between process and outcome for this treatment. Drawing on interpersonal theory and the broader psychotherapy literature, this study examined the contribution of patient expectations and the therapeutic alliance to outcomes in group CBT-I. For patients with low early treatment expectations for improvement, those perceiving the therapist as higher in affiliation had greater reduction in sleep problems. Perceiving the therapist as critically confrontive was generally associated with less treatment satisfaction, and particularly so for those individuals who came to treatment with high expectations for improvement. Critical confrontation also differentiated dropouts from continuers, with dropouts experiencing their therapist as more critically confrontive.

Original languageEnglish (US)
Pages (from-to)210-228
Number of pages19
JournalBehavioral sleep medicine
Volume5
Issue number3
DOIs
StatePublished - 2007

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Medicine (miscellaneous)
  • Psychology (miscellaneous)
  • Clinical Neurology

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