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dc.contributor.authorMalins, Samuel
dc.contributor.authorMorriss, Richard K.
dc.contributor.authorSchroder, Thomas
dc.contributor.authorBrown, Paula
dc.contributor.authorBoycott, Naomi
dc.date.accessioned2021-09-28T10:52:12Z
dc.date.available2021-09-28T10:52:12Z
dc.date.issued2021
dc.identifier.citationMalins, S., Moghaddam, N., Morriss, R. K., Schröder, T., Brown, P. & Boycott, N. (2021). The predictive value of patient, therapist, and in-session ratings of motivational factors early in remote cognitive behavioural therapy for severe health anxiety. British Journal of Clinical Psychology, 61(2), pp. 364-384.en_US
dc.identifier.other10.1111/bjc.12328
dc.identifier.urihttp://hdl.handle.net/20.500.12904/14884
dc.description.abstractObjectives Remote psychotherapy and the prevalence of Severe Health Anxiety (SHA) are both growing as a result of the COVID-19 pandemic. Remotely delivered Cognitive Behavioural Therapy (rCBT) for SHA is evidenced as effective, but many who seek help do not benefit. Motivational processes can influence outcomes, but it is unclear what assessment methods offer the best clinical utility in rCBT for SHA. Design This study compared the predictive validity of patient, therapist and in-session ratings of motivational factors taken at session two of rCBT for SHA among high healthcare users experiencing multimorbidity. Methods Motivational factors were assessed for 56 participants who attended at least two sessions of CBT for SHA delivered via video-conferencing or telephone. Following session two, therapists and patients completed online assessments of patient motivation. Two trained observers also rated motivational factors and therapeutic alliance from in-session interactions using session two recordings and transcripts. Multilevel modelling was used to predict health anxiety and a range of secondary health outcomes from motivation assessments. Results Where patients were more actively engaged in discussion of positive changes during session two, greater outcome improvements ensued in health anxiety and all secondary outcomes. Conversely, larger proportions of session two spent describing problems predicted poorer outcomes. Therapist and patient assessments of motivation did not predict health anxiety, but therapist assessments of client confidence and motivation predicted all secondary outcomes. Conclusions Motivation remains an important process in CBT when delivered remotely, and motivational factors may predict outcomes more consistently from in-session interactions, compared to self-reports.
dc.description.sponsorshipNational Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC-EM)en_US
dc.description.sponsorshipDevelopment and Skills Enhancement Awarden_US
dc.description.urihttps://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bjc.12328en_US
dc.language.isoenen_US
dc.subjectRemote consultationen_US
dc.subjectMotivationen_US
dc.subjectCognitive behavioural therapyen_US
dc.subjectAnxiety disordersen_US
dc.titleThe predictive value of patient, therapist, and in-session ratings of motivational factors early in remote cognitive behavioural therapy for severe health anxietyen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
refterms.dateFirstOnline12/09/2021
html.description.abstractObjectives Remote psychotherapy and the prevalence of Severe Health Anxiety (SHA) are both growing as a result of the COVID-19 pandemic. Remotely delivered Cognitive Behavioural Therapy (rCBT) for SHA is evidenced as effective, but many who seek help do not benefit. Motivational processes can influence outcomes, but it is unclear what assessment methods offer the best clinical utility in rCBT for SHA. Design This study compared the predictive validity of patient, therapist and in-session ratings of motivational factors taken at session two of rCBT for SHA among high healthcare users experiencing multimorbidity. Methods Motivational factors were assessed for 56 participants who attended at least two sessions of CBT for SHA delivered via video-conferencing or telephone. Following session two, therapists and patients completed online assessments of patient motivation. Two trained observers also rated motivational factors and therapeutic alliance from in-session interactions using session two recordings and transcripts. Multilevel modelling was used to predict health anxiety and a range of secondary health outcomes from motivation assessments. Results Where patients were more actively engaged in discussion of positive changes during session two, greater outcome improvements ensued in health anxiety and all secondary outcomes. Conversely, larger proportions of session two spent describing problems predicted poorer outcomes. Therapist and patient assessments of motivation did not predict health anxiety, but therapist assessments of client confidence and motivation predicted all secondary outcomes. Conclusions Motivation remains an important process in CBT when delivered remotely, and motivational factors may predict outcomes more consistently from in-session interactions, compared to self-reports.
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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