TY - JOUR
T1 - Effects of Therapeutic Alliance in Interpersonal Psychotherapy Among Adolescent Girls With Loss-of-Control Eating
AU - Ruzicka, Elizabeth B.
AU - Shomaker, Lauren B.
AU - Pyle, Laura
AU - Bakalar, Jennifer L.
AU - Shank, Lisa M.
AU - Crosby, Ross D.
AU - Wilfley, Denise E.
AU - Young, Jami F.
AU - Sbrocco, Tracy
AU - Brady, Sheila M.
AU - Gulley, Lauren D.
AU - Yanovski, Jack A.
AU - Tanofsky-Kraff, Marian
PY - 2024/3/15
Y1 - 2024/3/15
N2 - OBJECTIVE: Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may be important for IPT but has received little attention in weight-related interventions. This study evaluated associations of adolescent-reported therapeutic alliance during IPT with weight- and eating-related outcomes. METHODS: Secondary analyses of a randomized controlled trial were conducted to compare group IPT to health education (HE) for preventing excess weight gain among 113 girls (ages 12-17) with body mass index (BMI) at the 75th to 97th percentile and LOC eating. BMI and LOC eating were measured at baseline, 12 weeks (postintervention), and 1 year. Multilevel modeling was used to test associations between change in therapeutic alliance (from session 1 to session 12) and changes in weight- and eating-related outcomes (from postintervention to 1 year). Analyses were controlled for therapeutic alliance after session 1 and for baseline and postintervention outcome values; group assignment (IPT vs. HE) was a moderator. RESULTS: Increases in emotional bond were associated with decreased weight and with greater decreases in number of LOC eating episodes at 1 year in the IPT group (p<0.05) and with weight gain in the HE group (p<0.05). Greater task collaboration was related to greater weight gain at 1-year follow-up, regardless of group assignment (p<0.05). CONCLUSIONS: The association of therapeutic alliance during IPT with weight and LOC eating outcomes among adolescent girls merits further investigation.
AB - OBJECTIVE: Interpersonal psychotherapy (IPT) has been proposed for prevention of excess weight gain among adolescents with loss-of-control (LOC) eating. Mixed findings from a trial testing this conjecture warrant elucidation of potential outcome predictors. The therapeutic alliance (adolescent-facilitator emotional bond and task collaboration) may be important for IPT but has received little attention in weight-related interventions. This study evaluated associations of adolescent-reported therapeutic alliance during IPT with weight- and eating-related outcomes. METHODS: Secondary analyses of a randomized controlled trial were conducted to compare group IPT to health education (HE) for preventing excess weight gain among 113 girls (ages 12-17) with body mass index (BMI) at the 75th to 97th percentile and LOC eating. BMI and LOC eating were measured at baseline, 12 weeks (postintervention), and 1 year. Multilevel modeling was used to test associations between change in therapeutic alliance (from session 1 to session 12) and changes in weight- and eating-related outcomes (from postintervention to 1 year). Analyses were controlled for therapeutic alliance after session 1 and for baseline and postintervention outcome values; group assignment (IPT vs. HE) was a moderator. RESULTS: Increases in emotional bond were associated with decreased weight and with greater decreases in number of LOC eating episodes at 1 year in the IPT group (p<0.05) and with weight gain in the HE group (p<0.05). Greater task collaboration was related to greater weight gain at 1-year follow-up, regardless of group assignment (p<0.05). CONCLUSIONS: The association of therapeutic alliance during IPT with weight and LOC eating outcomes among adolescent girls merits further investigation.
KW - Child/adolescent psychiatry
KW - Depressive disorders
KW - Feeding and eating disorders
KW - Interpersonal psychotherapy
KW - Loss of control
KW - Therapeutic alliance
UR - http://www.scopus.com/inward/record.url?scp=85187959637&partnerID=8YFLogxK
U2 - 10.1176/appi.psychotherapy.20230011
DO - 10.1176/appi.psychotherapy.20230011
M3 - Article
C2 - 38196343
AN - SCOPUS:85187959637
SN - 0002-9564
VL - 77
SP - 7
EP - 14
JO - American Journal of Psychotherapy
JF - American Journal of Psychotherapy
IS - 1
ER -