Type
Text
Type
Dissertation
Advisor
Moyer, Anne | Freitas, Antonio | O'Leary, Daniel | Pessin, Hayley.
Date
2017-05-01
Keywords
Psychology -- Oncology -- Mental health | alliance, attrition, matching, meaning-centered, patient preferences
Department
Department of Social/Health Psychology
Language
en_US
Source
This work is sponsored by the Stony Brook University Graduate School in compliance with the requirements for completion of degree.
Identifier
http://hdl.handle.net/11401/76795
Publisher
The Graduate School, Stony Brook University: Stony Brook, NY.
Format
application/pdf
Abstract
The current study aims to identify whether demographic, disease-related, psychological, and spirituality/religiosity variables predict patients’ preference for Individual Meaning-Centered Psychotherapy (IMCP) compared to Individual Supportive Psychotherapy (ISP). In addition, this study aims to examine whether assigning patients to their preferred therapy arm impacts both their engagement with their assigned treatment in a randomized controlled trial (RCT) and their therapeutic alliance mid-way through treatment. Data for these analyses were drawn from a RCT comparing IMCP, ISP, and Enhanced Usual Care (EUC) in a sample of patients with advanced cancer. Results demonstrated that patients with higher levels of education were more likely to endorse IMCP as their preference compared to ISP. All other predictors (age, cancer type, depression, anxiety, hopelessness, desire for hastened death, spirituality and religiosity) did not significantly predict preference for IMCP. Matching to treatment did not significantly impact engagement with the treatment, as measured by number of sessions attended. However, patients who were matched to their preferred treatment scored higher on the Working Alliance Inventory than patients who were mismatched to their preferred treatment. This difference was significant only in the case of those who preferred IMCP; patients who preferred and were assigned to IMCP scored significantly higher on the Working Alliance Inventory than patients who preferred IMCP but were assigned to ISP. Possible reasons include that IMCP is a novel therapy that could not be found elsewhere. These results imply that, when comparing novel therapies with standard treatments, as is often the case in RCTs, patients who prefer the novel treatment but do not receive it may feel particularly disappointed that their only opportunity for an innovative therapy was unsuccessful, hindering their therapeutic alliance and potentially their outcomes. | The current study aims to identify whether demographic, disease-related, psychological, and spirituality/religiosity variables predict patients’ preference for Individual Meaning-Centered Psychotherapy (IMCP) compared to Individual Supportive Psychotherapy (ISP). In addition, this study aims to examine whether assigning patients to their preferred therapy arm impacts both their engagement with their assigned treatment in a randomized controlled trial (RCT) and their therapeutic alliance mid-way through treatment. Data for these analyses were drawn from a RCT comparing IMCP, ISP, and Enhanced Usual Care (EUC) in a sample of patients with advanced cancer. Results demonstrated that patients with higher levels of education were more likely to endorse IMCP as their preference compared to ISP. All other predictors (age, cancer type, depression, anxiety, hopelessness, desire for hastened death, spirituality and religiosity) did not significantly predict preference for IMCP. Matching to treatment did not significantly impact engagement with the treatment, as measured by number of sessions attended. However, patients who were matched to their preferred treatment scored higher on the Working Alliance Inventory than patients who were mismatched to their preferred treatment. This difference was significant only in the case of those who preferred IMCP; patients who preferred and were assigned to IMCP scored significantly higher on the Working Alliance Inventory than patients who preferred IMCP but were assigned to ISP. Possible reasons include that IMCP is a novel therapy that could not be found elsewhere. These results imply that, when comparing novel therapies with standard treatments, as is often the case in RCTs, patients who prefer the novel treatment but do not receive it may feel particularly disappointed that their only opportunity for an innovative therapy was unsuccessful, hindering their therapeutic alliance and potentially their outcomes. | 130 pages
Recommended Citation
Marziliano, Allison, "Predicting Patient Preferences for Individual Meaning-Centered Psychotherapy and the Impact of Matching to Preference on Treatment Engagement and Therapeutic Alliance" (2017). Stony Brook Theses and Dissertations Collection, 2006-2020 (closed to submissions). 2673.
https://commons.library.stonybrook.edu/stony-brook-theses-and-dissertations-collection/2673