Page 69 - Personality disorders and insecure attachment among adolescents
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Table 2: RCI between first- and last session scores C-SRS for completers and dropouts Completers Dropouts Total
N%N%N% Significantlyincreased 28 40.6 9 25.0 37 35.2 No significant change 36 52.2 12 33.3 48 45.7 Significantly decreased 5 7.2 15 41.7 20 19.0
Mixed model analyses showed no differences (p =.665) in C-SRS scores over time between dropouts and completers, implicating that dropout cannot be predicted from the progression of C-SRS scores. A GEE-analysis did not reveal dropout to be a significant predictor of significant (RCI) decreases in C-SRS scores (p = .730). Therefore the next step was to identify the last five sessions of therapy and compare the differences in C-SRS scores between these sessions. No differences were found between completers and dropout in comparison of the fifth- and fourth-last session. Comparison of the third-last and the second-last session showed that 7.1% (n = 3) of the completers (N = 42) had a significant (RCI) decrease in C-SRS score between these sessions, while for drop-out (N = 17) this was 35.3% (n = 6) (df = 1, χ2 = 7.419, p = .006). Subsequently, a comparison of the C-SRS score of the second-last and the last session showed that 4.0% (n = 2) of the completers (N = 50) had a significant (RCI) decrease in C-SRS score between these sessions, while for drop-out (N = 30) this was 26.7% (n = 8) (df = 1, χ2 = 8.808, p = .003) (table 2). During the last three sessions 7.2% (n = 5) of the completers showed a significant decrease in C-SRS scores, compared to 38.9% (n =14) of the dropouts (df = 1, χ2 = 15.98, p < .001). The differences between sessions for all respondents for all sessions (N = 1906) showed that 324 times (14.3%) a significant decrease (RCI) in C-SRS scores occurred.
Discussion
The aim of our study was to gain deeper insights on the association between the quality of the therapeutic relationship and treatment termination status among high risk adolescents receiving intensive MBT. We measured the therapeutic relationship during group therapy with the C-SRS, with which the adolescent rated the therapeutic group alliance. No differences were found in the initial scores of the C-SRS, indicating that dropouts and completers did not differ in the way they experience the therapeutic alliance at the start of therapy. The development of C-SRS scores during the course of therapy however, was different for the two groups: completers showed improving scores of the therapeutic relationship during the course of therapy, while dropouts showed declining scores during the course of therapy. These differences however occurred mainly at the end of the treatment course.
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