A. C. Del Re

A. C. Del Re
Naval Health Research Center · Health and Behavioral Sciences

PhD

About

59
Publications
62,741
Reads
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3,613
Citations
Research Experience
March 2013 - present
VA Palo Alto Health Care System
Position
  • Research Health Scientist
October 2011 - February 2013
VA Palo Alto & Stanford University
Position
  • Research Post-doctoral Fellow
September 2011 - March 2013
Stanford University
Position
  • PostDoc Position
Education
September 2005 - August 2011
University of Wisconsin–Madison
Field of study
  • Counseling Psychology
September 2002 - December 2004
University of New Mexico
Field of study
  • Counselor Education

Publications

Publications (59)
Article
Full-text available
Objective: Even though the early alliance has been shown to robustly predict posttreatment outcomes, the question whether alliance leads to symptom reduction or symptom reduction leads to a better alliance remains unresolved. To better understand the relation between alliance and symptoms early in therapy, we meta-analyzed the lagged session-by-se...
Chapter
The alliance continues to be one of the most investigated variables related to success in psychotherapy. In this chapter, the authors define and illustrate the alliance (also conceptualized as therapeutic alliance or working alliance) and then present a meta-analysis of 295 independent studies that covered more than 30,000 patients for face-to-face...
Article
In 2014, Macnamara, Hambrick, and Oswald published a meta-analysis of studies questioning the strength of the association between deliberate practice and performance. In this brief report, the correlation reported by Macnamara et al. (2014) is placed in the context of other well-known associations. Additionally, a re-analysis of the studies include...
Article
The alliance continues to be one of the most investigated variables related to success in psychotherapy irrespective of theoretical orientation. We define and illustrate the alliance (also conceptualized as therapeutic alliance, helping alliance, or working alliance) and then present a meta-analysis of 295 independent studies that covered more than...
Preprint
Full-text available
Open access: http://psycnet.apa.org/fulltext/2018-23951-001.pdf Abstract: The alliance continues to be one of the most investigated variables related to success in psychotherapy irrespective of theoretical orientation. We define and illustrate the alliance (also conceptualized as therapeutic alliance, helping alliance or working alliance) and then...
Article
Full-text available
Free download: https://doi.org/10.1080/10503307.2018.1430390 (copy&past) Psychotherapy researchers have had a long-standing interest in developing and applying meta-analytic methods.This Special Section aims to provide a synopsis of lasting evidence-based considerations and challenges present in psychotherapy meta-analyses and psychological interve...
Article
Meta-analysis of psychotherapy intervention research normally examines differences between treatment groups and some form of comparison group (e.g., wait list control; alternative treatment group). The effect of treatment is normally quantified as a standardized mean difference (SMD). We describe procedures for computing unbiased estimates of the p...
Article
Full-text available
Objective: Three recent meta-analyses have made the claim, albeit with some caveats, that cognitive-behavioral treatments (CBT) are superior to other psychotherapies, in general or for specific disorders (e.g., social phobia). Method: The purpose of the present article was to examine four issues in meta-analysis that mitigate claims of CBT super...
Article
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Purposes: The objective of this study was to determine the percentage of veterans with active hepatitis C virus (HCV) infection who were deemed to be candidates for treatment and to identify factors associated with treatment ineligibility. Methods: This was a multisite, retrospective cohort analysis of veterans with HCV infection within the Vete...
Article
Historically, the argument that some psychotherapy orientations produced more sustainable outcomes at follow-up than others contributed to the split of the psychotherapy community into different camps. The most up-to-date meta-analytic evidence indicates a surprisingly different, yet consistent picture: There is marginal empirical evidence for the...
Article
Full-text available
This study provides an example of how healthcare system-wide progress in implementation of opioid-therapy guideline recommendations can be longitudinally assessed and then related to subsequent opioid-prescribed patient health and safety outcomes. Using longitudinal linear mixed effects analyses, we determined that in the Department of Veterans Aff...
Article
Meta-analysis has played a key role in psychotherapy research for nearly 40 years. There is now an opportunity for technology to assist with transparent and open meta-analyses. The authors describe an open-access database of effect sizes and a corresponding web application for performing meta-analyses, viewing the database, and downloading effect s...
Article
Bell, Marcus, and Goodlad (2013) recently conducted a meta-analysis of randomized controlled additive trials and found that adding an additional component to an existing treatment vis-à-vis the existing treatment produced larger effect sizes on targeted outcomes at 6-months follow-up than at termination, an effect they labeled as a sleeper effect....
Article
Full-text available
Die Arbeitsallianz ist das am meisten untersuchte therapiebezogene Prozessmerkmal weltweit. Zwischen 2000 und 2014 sind dazu jährlich um die 300 Fachpublikationen veröf- fentlicht worden. Die Gründe für die Popularität des Konzepts liegen möglicherweise in der intuitiven Erfahrung vieler Psychotherapeuten, dass eine insgesamt „positive“ Arbeitskoll...
Article
Full-text available
Meta-analysis is a set of statistical procedures used for providing transparent, objective, and replicable summaries of research findings. This tutorial demonstrates the most common procedures on conducting a meta-analysis using the R statistical software program. It begins with an introduction to meta-analysis along with detailing the preliminary...
Article
Full-text available
Background Utilization of extended release naltrexone (XRN) for alcohol use disorders (AUDs) in the U.S. Veterans Health Administration (VHA) has been limited, perhaps due to high cost, lack of established superiority over less expensive alternatives including oral naltrexone, and related formulary restrictions. Despite these barriers, pockets of h...
Article
Objective: Pharmacotherapy is an effective adjunct to behavioral interventions to treat obesity; although it is unclear how often medications are integrated into obesity treatment plans and for which patients in the Veterans Health Administration (VHA). Methods: A retrospective cohort study was conducted that examined variation in and predictors...
Article
Full-text available
As mindfulness-based interventions become increasingly widespread, interest has grown in better understanding which features of these treatments produce beneficial effects. The present study examined the relative contribution of mindfulness practice time and practice quality in predicting psychological functioning (negative affect, emotion regulati...
Article
Background Influenced by several trials and reviews highlighting positive outcomes, topiramate is increasingly prescribed as a treatment for alcohol use disorders (AUDs). The only previously published meta-analysis of topiramate for AUDs was limited by a sample of only 3 randomized, placebo-controlled trials (RCTs).MethodsA systematic search identi...
Article
To determine the relations between obstructive sleep apnea (OSA) diagnosis, the likelihood of being diagnosed with a psychological condition, among obese veterans, after accounting for severity of obesity and the correlated nature of patients within facility. We hypothesized that (1) individuals with a diagnosis of OSA would be more likely to recei...
Article
Full-text available
Health care systems initiating major behavioral health programs often face challenges with variable implementation and uneven patient engagement. One large health care system, Veterans Health Administration (VHA), recently initiated the MOVE!(R) Weight Management Program, but it is unclear if veterans most in need of MOVE!(R) services are accessing...
Article
Full-text available
Intention to treat (ITT) is an analytic strategy for reducing potential bias in treatment effects arising from missing data in randomised controlled trials (RCTs). Currently, no universally accepted definition of ITT exists, although many researchers consider it to require either no attrition or a strategy to handle missing data. Using the reports...
Article
Full-text available
When mental health is monitored over the course of treatment, many clients report strong and stable changes, particularly early in psychotherapy. Such changes can occur both in singular events, such as sudden gains in particular symptoms, and more comprehensive ways across the World Health Organization definition of health (WHO, 1948), which includ...
Article
The purpose of Study 1 was to examine the relative efficacy of evidence-based treatments (EBTs) when compared to treatment-as-usual (TAU) for adults diagnosed with a personality disorder (PD). The purpose of Study 2 was to investigate the strength of the differences between bona fide psychotherapeutic treatments for PDs. Two separate computerized s...
Article
Placebo group improvement in pharmacotherapy trials has been increasing over time across several pharmacological treatment areas. However, it is unknown to what degree increasing improvement has occurred in pharmacotherapy trials for alcohol use disorders or what factors may account for placebo group improvement. This meta-analysis of 47 alcohol ph...
Article
Full-text available
As a quality improvement metric, the US Veterans Health Administration (VHA) monitors the proportion of patients with alcohol use disorders (AUD) who receive FDA approved medications for alcohol dependence (naltrexone, acamprosate, and disulfiram). Evidence supporting the off-label use of the antiepileptic medication topiramate to treat alcohol dep...
Article
Full-text available
The purpose of this meta analysis was to examine the moderating impact of substance use disorder as inclusion/exclusion criterion as well as the percentage of racial/ethnic minorities on the strength of the alliance-outcome relationship in psychotherapy. It was hypothesized that the presence of a Diagnostic and Statistical Manual of Mental Disorder...
Article
Effective antiretroviral therapy has led to substantial improvements in health-related outcomes among individuals with HIV. Despite advances in HIV pharmacotherapy, suboptimal medication adherence remains a significant barrier to successful treatment. Although several factors have been associated with medication adherence in the extant literature,...
Article
Full-text available
Recently, Cipriani and colleagues examined the relative efficacy of 12 new-generation antidepressants on major depression using network meta-analytic methods. They found that some of these medications outperformed others in patient response to treatment. However, several methodological criticisms have been raised about network meta-analysis and Cip...
Data
R code to Replicate Output of MTC Meta-Analysis. (R)
Article
Full-text available
Background: The apolipoprotein-E (APOE) ε4 allele is a risk factor for vascular dementia and Alzheimer's disease. Recent studies are equivocal with regards to whether or not the ε4 allele confers increased risk for the development of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND), but suggest that age and/or disease s...
Article
Full-text available
Description This is an R-Commander plug-in for meta-analysis. This package enables the user to conduct a meta-analysis in a menu-driven, graphical user interface environment (e.g., SPSS). It uses recommended procedures as described in The Handbook of Research Synthesis and Meta-Analysis (Cooper, Hedges, & Valentine, 2009).
Article
Background: Oral naltrexone is an FDA-approved medication for treating alcohol use disorders. Although its efficacy has been supported in multiple clinical trials, an earlier review found that its effect sizes (ESs) on relapse to heavy drinking and, to a lesser extent, percent days drinking were smaller in more recent trials and in multicenter tha...
Article
Full-text available
Abstract Mindfulness-Based Stress Reduction (MBSR) is an experientially based group intervention empirically supported to reduce psychological symptomology. Although MBSR has shown to be an effective intervention, little is known about which facets of the intervention are important in producing positive outcomes. This study tested several aspects o...
Article
Although the relationship between the therapeutic alliance and outcome has been supported consistently across several studies and meta-analyses, there is less known about how the patient and therapist contribute to this relationship. The purpose of this present meta-analysis was to (1) test for therapist effects in the alliance-outcome correlation...
Article
Full-text available
Prior meta-analyses have found a moderate but robust relationship between alliance and outcome across a broad spectrum of treatments, presenting concerns, contexts, and measurements. However, there continues to be a lively debate about the therapeutic role of the alliance, particularly in treatments that are tested using randomized clinical trial (...
Article
The aim of this study was to examine the relative efficacy of evidence-based treatments (EBTs) versus treatment-as-usual (TAU) in routine care for anxiety and depression in adults. A computerized search of studies that directly compared an EBT with a TAU was conducted. Meta-analytic methods were used to estimate effectiveness of EBTs relative to TA...
Article
Full-text available
The patterns of growth and development of the therapeutic alliance over the course of therapy have been of continued interest to psychotherapy researchers. The purpose of this study was to investigate whether a simple institutional metacommunication intervention with clients had an effect on the development of the alliance. This adjunctive instruct...
Article
Full-text available
This article reports on a research synthesis of the relation between alliance and the outcomes of individual psychotherapy. Included were over 200 research reports based on 190 independent data sources, covering more than 14,000 treatments. Research involving 5 or more adult participants receiving genuine (as opposed to analogue) treatments, where...
Article
Objective: The aim of this study was to examine the relative efficacy of evidence-based treatments (EBTs) versus treatment-as-usual (TAU) in routine care for anxiety and depression in adults. Method: A computerized search of studies that directly compared an EBT with a TAU was conducted. Meta-analytic methods were used to estimate the effectiveness...
Article
Full-text available
This is an integrated meta-analysis package for conducting a research synthesis with mean differences data. One of the unique features of this package is in its integration of user-friendly functions to facilitate statistical analyses at each stage in a meta-analysis with mean differences. It uses recommended procedures as described in The Handbook...
Article
This is an R-Commander plug-in for the MAd package (Meta-Analysis with Mean Differences). This package enables the user to conduct a meta-analysis in a menu-driven, graphical user interface environment (e.g., SPSS), while having the full statistical capabilities of R and the MAd package. The MAd package itself contains a variety of useful functions...
Article
Many researchers accept that trauma-focused treatments are superior to non-trauma focused treatments for Post-Traumatic Stress Disorder (PTSD). However, Benish, Imel, and Wampold (2008) recently published a meta-analysis of clinical trials directly comparing 'bona fide' PTSD treatments that failed to reject the null hypothesis that PTSD treatments...
Article
Full-text available
This package contains several functions for calculating and converting various statistics, such as a t-test or p-value and sample size, to effect size estimates of d (mean difference), g (unbiased estimate of d), r (correlation coefficient), z (Fisher's z), and log odds ratio. The variance of these estimates are also computed. These calculation/con...
Article
Full-text available
This is an integrated meta-analysis package for conducting a correlational research synthesis. One of the unique features of this package is in its integration of user-friendly functions to facilitate statistical analyses at each stage in a meta-analysis with correlations. It uses recommended procedures as described in The Handbook of Research Synt...

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Cited By

Projects

Projects (2)
Project
The first two APA Task Forces "Psychotherapy Relationships that Work" proved professional successes (Norcross, 2002, 2011). The meta-analyses brought science and practice together under the auspices of the APA Psychotherapy Division and the APA Society of Clinical Psychology on compelling topics that spoke to practitioners and researchers alike. The present meta analysis summaries the literature of "The Alliance in (adult) Individual Psychotherapy" based on over 6000 new hits published between 2010 and 2017.
Project
The proposed SNSF-project (PP00P1_163702) has a common theme, i.e., the understanding of the enduring efficacy of psychological treatments in individuals who suffer from general anxiety disorder (GAD). There is meta-analytic evidence that bona fide psychotherapy is an effective treatment for GAD, but also for individuals that suffers from anxiety and depression. Nonetheless, in spite of the empirical evidence of the overall efficacy, there is a lack of randomized controlled studies that systematically investigate the therapists’ variability (i. e. therapist effects) within the very same treatment protocol. The development of study designs to investigate potential health professional effects along treatment effects is a general claim for human interventions.