Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial
Introduction Alliance ruptures constitute a high risk of premature treatment termination and poor psychotherapy outcome. The Alliance-Focused Training (AFT) is a promising transtheoretical approach to enhance therapists’ skills in dealing with alliance ruptures.Methods and analysis To evaluate the e...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/7/e098343.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850074840864653312 |
|---|---|
| author | Anne Daubmann Antonia Zapf Antje Gumz Frank Jacobi Denise Kästner Laurence Reuter Carmen Martinez Moura Klarissa Ehlers Catherine F Eubanks John Christopher Muran Timothy Anderson Ramona Stöckl Georg Schwanitz Lena Stegemann Lana Rohr Ulrike Willutzki |
| author_facet | Anne Daubmann Antonia Zapf Antje Gumz Frank Jacobi Denise Kästner Laurence Reuter Carmen Martinez Moura Klarissa Ehlers Catherine F Eubanks John Christopher Muran Timothy Anderson Ramona Stöckl Georg Schwanitz Lena Stegemann Lana Rohr Ulrike Willutzki |
| author_sort | Anne Daubmann |
| collection | DOAJ |
| description | Introduction Alliance ruptures constitute a high risk of premature treatment termination and poor psychotherapy outcome. The Alliance-Focused Training (AFT) is a promising transtheoretical approach to enhance therapists’ skills in dealing with alliance ruptures.Methods and analysis To evaluate the effectiveness of Modified AFT with doubling (MAFT-D), a randomised, patient and evaluator-blinded, multicentre trial was designed comparing MAFT-D (delivered to trainee therapists and supervisors) and psychotherapy training/treatment as usual (TAU) for therapists (n=120) and their patients with depressive disorders (n=240). A total of 17 cooperating centres, each offering either cognitive-behavioural or psychodynamic psychotherapy training, will contribute to recruitment. Stratification by centre (both for therapists and patients) and hence therapeutic approach (cognitive-behavioural vs psychodynamic psychotherapies), and by comorbid personality disorder (yes vs no, for patients) will be carried out. The two hierarchically ordered primary hypotheses are: In MAFT-D compared with TAU, a stronger reduction of depressive symptoms and a lower rate of patient dropout is expected from baseline to 20 weeks after baseline. Follow-up assessments are planned at 35 weeks, 20 months and 36 months postbaseline to evaluate the persistence of effects. Secondary patient-related and therapist-related outcomes as well as predictors, moderators and mediators of change will be investigated. Mixed models with repeated measures will be used for the primary analyses.Ethics and dissemination Ethical approvals were obtained by the institutional ethics review board of the main study centre as well as by review boards in each federal state where one or more cooperating centres are located (secondary votes). Following the Consolidated Standards of Reporting Trials statement for non-pharmacological trials, results will be reported in peer-reviewed scientific journals and disseminated to patient organisations and media.Trial registration number DRKS00014842; https://drks.de/search/de/trial/DRKS00014842. |
| format | Article |
| id | doaj-art-a85f7e3a19964bdfa69e41629eaabbc0 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-a85f7e3a19964bdfa69e41629eaabbc02025-08-20T02:46:28ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-098343Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trialAnne Daubmann0Antonia Zapf1Antje Gumz2Frank Jacobi3Denise Kästner4Laurence Reuter5Carmen Martinez Moura6Klarissa Ehlers7Catherine F Eubanks8John Christopher Muran9Timothy Anderson10Ramona Stöckl11Georg Schwanitz12Lena Stegemann13Lana Rohr14Ulrike Willutzki15Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Psychosomatics and Psychotherapy, Psychologische Hochschule Berlin, Berlin, GermanyDepartment of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, GermanyDepartment of Psychosomatics and Psychotherapy, Psychologische Hochschule Berlin, Berlin, GermanyDepartment of Psychosomatics and Psychotherapy, Psychologische Hochschule Berlin, Berlin, GermanyDepartment of Psychosomatics and Psychotherapy, Psychologische Hochschule Berlin, Berlin, GermanyDepartment of Psychosomatics and Psychotherapy, Psychologische Hochschule Berlin, Berlin, GermanyDerner School of Psychology, Adelphi University, Garden City, New York, USADerner School of Psychology, Adelphi University, Garden City, New York, USADepartment of Psychology, Ohio University, Athens, Ohio, USAClinical Trial Office, Charité Universitätsmedizin Berlin, Berlin, GermanyClinical Trial Office, Charité Universitätsmedizin Berlin, Berlin, GermanyClinical Trial Office, Charité Universitätsmedizin Berlin, Berlin, GermanyClinical Trial Office, Charité Universitätsmedizin Berlin, Berlin, GermanyDepartment of Psychology and Psychotherapy, University Witten/Herdecke, Witten, GermanyIntroduction Alliance ruptures constitute a high risk of premature treatment termination and poor psychotherapy outcome. The Alliance-Focused Training (AFT) is a promising transtheoretical approach to enhance therapists’ skills in dealing with alliance ruptures.Methods and analysis To evaluate the effectiveness of Modified AFT with doubling (MAFT-D), a randomised, patient and evaluator-blinded, multicentre trial was designed comparing MAFT-D (delivered to trainee therapists and supervisors) and psychotherapy training/treatment as usual (TAU) for therapists (n=120) and their patients with depressive disorders (n=240). A total of 17 cooperating centres, each offering either cognitive-behavioural or psychodynamic psychotherapy training, will contribute to recruitment. Stratification by centre (both for therapists and patients) and hence therapeutic approach (cognitive-behavioural vs psychodynamic psychotherapies), and by comorbid personality disorder (yes vs no, for patients) will be carried out. The two hierarchically ordered primary hypotheses are: In MAFT-D compared with TAU, a stronger reduction of depressive symptoms and a lower rate of patient dropout is expected from baseline to 20 weeks after baseline. Follow-up assessments are planned at 35 weeks, 20 months and 36 months postbaseline to evaluate the persistence of effects. Secondary patient-related and therapist-related outcomes as well as predictors, moderators and mediators of change will be investigated. Mixed models with repeated measures will be used for the primary analyses.Ethics and dissemination Ethical approvals were obtained by the institutional ethics review board of the main study centre as well as by review boards in each federal state where one or more cooperating centres are located (secondary votes). Following the Consolidated Standards of Reporting Trials statement for non-pharmacological trials, results will be reported in peer-reviewed scientific journals and disseminated to patient organisations and media.Trial registration number DRKS00014842; https://drks.de/search/de/trial/DRKS00014842.https://bmjopen.bmj.com/content/15/7/e098343.full |
| spellingShingle | Anne Daubmann Antonia Zapf Antje Gumz Frank Jacobi Denise Kästner Laurence Reuter Carmen Martinez Moura Klarissa Ehlers Catherine F Eubanks John Christopher Muran Timothy Anderson Ramona Stöckl Georg Schwanitz Lena Stegemann Lana Rohr Ulrike Willutzki Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial BMJ Open |
| title | Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial |
| title_full | Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial |
| title_fullStr | Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial |
| title_full_unstemmed | Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial |
| title_short | Modified Alliance-Focused Training with Doubling as an integrative approach to improve therapists’ competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression: study protocol of a randomised controlled multicentre trial |
| title_sort | modified alliance focused training with doubling as an integrative approach to improve therapists competencies in dealing with alliance ruptures and prevent negative outcomes in psychotherapy for depression study protocol of a randomised controlled multicentre trial |
| url | https://bmjopen.bmj.com/content/15/7/e098343.full |
| work_keys_str_mv | AT annedaubmann modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT antoniazapf modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT antjegumz modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT frankjacobi modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT denisekastner modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT laurencereuter modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT carmenmartinezmoura modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT klarissaehlers modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT catherinefeubanks modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT johnchristophermuran modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT timothyanderson modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT ramonastockl modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT georgschwanitz modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT lenastegemann modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT lanarohr modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial AT ulrikewillutzki modifiedalliancefocusedtrainingwithdoublingasanintegrativeapproachtoimprovetherapistscompetenciesindealingwithalliancerupturesandpreventnegativeoutcomesinpsychotherapyfordepressionstudyprotocolofarandomisedcontrolledmulticentretrial |