Terje Tilden

Modum Bad · Research Institute

De therapeutische alliantie of werkrelatie heeft in de psychotherapie de status ‘gemeenschappelijke factor’ gekregen, vanwege het robuuste verband met de uitkomst van behandelingen. De opdracht voor ons werkveld is nu om een genuanceerder beeld te krijgen van de invloed van de alliantie op de mate waarin tijdens de therapie vooruitgang wordt geboek...

Background: Routine Outcome Monitoring (ROM) systems have been used to monitor how a client’s life changes over the course of therapy. However, if a ROM system is to be used, the system should have sufficient construct validity to warrant its usage. In the current study we sought to test the construct of the “individual problems and strengths” (IPS...

In this article, we present and expound upon the metatheory which serves as the foundation of Integrative Systemic Therapy (IST). IST gives a perspective to therapeutic practice which transcends established ideas about specific therapeutic models and delimited treatment contexts. The application of IST gives the clinician an overview and understand...

Background: Routine outcome monitoring (ROM) is in this article defined as a tool for feedback-informed therapy where clients' therapy relevant information is applied in real-time therapy. Because family therapy represents a comprehensive clinical setting, ROM is experienced as particularly useful. Aims: In a vignette from family therapy practic...

In a Norwegian study of 73 couples attending a residential couple therapy program lasting between 6 and 12 weeks, weekly self-report data on therapy alliance and couple satisfaction were collected using routine outcome monitoring (ROM). The aim was to show how dyadic analyses could be applied to examine the predictive association between alliances...

In the present study we aim to increase our knowledge of the relationship between childhood trauma and outcome in couple therapy. We sampled participants based on their sub-optimal responses to treatment as well as one member of the dyad having reported experiences of childhood trauma. Six participants constituting three couples were included. All...

These data stem from 841 clients at different couple and family therapy sites in Norway that was collected between 2010 and 2016. They all answered the Individual Problems and Strengths scale (IPS) that is a part of the Systemic Therapy Inventory of Change (STIC) system in addition to some demographic variables. In addition to the 22 items construc...

This study aimed to examine if survivors of childhood abuse responded differently to couple and family therapy compared with patients without such experiences. The study included 36 couples and nine individuals (N = 81). Of these participants, 30.3% had disclosed being exposed to and/or physical or sexual abuse during childhood. All participants of...

Objective Cross-sectional data show that post-traumatic stress disorder (PTSD) patients often have increased levels of circulating inflammatory markers. There is, however, still a paucity of longitudinal studies with long follow-up times on levels of cytokines in such patients. The current study assesses patients with and without PTSD diagnosis 1 y...

The therapeutic alliance has gained status as a common factor in psychotherapy due to its robust predictive relationship with outcome. The current challenge in our field is to gain a more nuanced understanding of alliance's impact on the progress of treatment over the course of therapy. In the current study, alliance was measured on 3 dimensions: (...

Objective In couple therapy clients often suffer from a blend of individual psychiatric symptoms as well as severe relational distress. However, research is inconclusive on whether relational change predicts symptom change or vice versa. Because answers to this question could have important clinical implications on what to focus on in couple therap...

Psychotherapy research aims to investigate predictors and moderators of treatment outcome, but there are few consistent findings. This study aimed to investigate cytokines in patients undergoing treatment for anxiety disorders and whether the level of cytokines moderated the treatment outcome. Thirty-seven patients with comorbid and treatment-resis...

Governmental requirements of making use of evidence-based treatments on one side, and the family therapy field’s pluralism on knowledge sources on the other, may create a dilemma for the systemic clinician. This dilemma has also an epistemological relevance on research within the systemic field, addressing which research questions are relevant and...

Introduction: Couple violence (CV) affects many, and the consequences of those actions are grave, not only for the individual suffering at the hand of the perpetrator but also for the other persons in the family. Violence often happens among more than just the adults within one family. Even if CV has been thoroughly investigated in the general pop...

Objective Cross-sectional data show elevated levels of circulating cytokines in psychiatric patients. The literature is divided concerning anti-inflammatory drugs’ ability to relieve symptoms, questioning a causal link between inflammatory pathways and psychiatric conditions. We hypothesized that the development of circulating cytokine levels is re...

Work functioning has significance for the individual and society but has rarely been used as an outcome measure for psychotherapy. Work‐related factors such as work satisfaction and working hours impact personal and relational life. More than half of those on sick leave suffer from social problems such as family‐related distress or mental health is...

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between t...

This replication study examined the change over time and the relationship between depressive symptoms and dyadic adjustment during residential couple therapy and at one- and three-year follow-up. Mixed models were used in the analyses, and a disaggregation procedure was applied to examine the results on a between-person as well as on a within-perso...

Background: A reciprocal relationship between activated innate immune system and changes in mood and behavior has been established. There is still a paucity of knowledge on how the immune system responds during psychiatric treatment. We aimed to explore circulating cytokines and assess psychiatric symptom severity scores during 12 weeks of inpatien...

Background Depression, anxiety, excessive alcohol use and trauma history are associated with elevated levels of pro-inflammatory cytokines. Few have investigated cytokines prospectively during psychiatric treatment. We aimed to explore predictors of change in cytokine levels during treatment. Methods Serum blood samples and psychometric scores were...

As an introduction that sets the agenda for this book, this chapter gives background information about some characteristics of the couple and family therapy field. The influence from professional, ethical, political, and legal powers on the growth and development of this field has in particular addressed the objective of user involvement. Feedback...

The Family Unit at Modum Bad in Vikersund, Norway, offers residential, intensive treatment for couples and families within a national psychiatric hospital for adults. The typical clients are characterized as multiproblem families that have longstanding, severe problems across a variety of life areas where previous help was inadequate. The treatment...

Many good projects fail despite good intentions and general support. When projects in addition involve research in clinical environments, the risk is even greater for failure. This is particularly the case when introducing quantitative research into couple and family therapy contexts, challenging core theoretical assumptions of the systemic field....

The editors sum up some headlines throughout the book, such as the development and status of couple and family therapy in relation to other psychotherapy disciplines. Further, the editors discuss what impact the use of routine outcome monitoring (ROM) may have on our field ahead, for instance in affecting the therapeutic relationship between the cl...

This research-to-practice manual introduces Routine Outcome Monitoring (ROM), a feedback-based approach to preventing impasses and relapses in couple and family therapy as well as within other psychotherapy approaches. This book discusses how ROM has been developed and experienced within the Norwegian couples and family therapy community in line wi...

The relationship between common process variables (optimism, empathy, safety/trust, insight) and specific process variables (communication and conflict management skills [CCM]) was studied from the perspectives of 176 couples and their therapists in Norway. In a mixed-model analysis, clients and therapists reported that CCM skills predicted clients...

This study examined the relationship between depressive symptoms and dyadic adjustment, as well as between interpersonal problems and dyadic adjustment, during residential couple therapy and at a three-year follow-up (N=106). Mixed models were used in the analyses. Significant improvement (p<.001) occurred on all measures from admission to discharg...

This Norwegian couple therapy effectiveness therapy study explored the course and prediction of relationships between depressive symptoms, interpersonal problems, and dyadic adjustment during residential treatment and over a 3-year post-treatment period (N=117). All measures indicated significant improvement (p<.001) between admission and discharge...

A clinical sample of adult patients suffering from relational distress and concurrent psychiatric symptoms was followed from admission, through residential couple therapy, to 1-year follow-up. At follow-up, 9.8% were separated. The remaining couples showed significant improvement in dyadic adjustment at posttreatment. However, at 1-year follow-up,...

An inpatient family therapy program for treating complex combinations of individual, couple, and family problems is presented within a holistic treatment framework. The treatment context and scheduled program form treatment guidelines, yet the single case treatment approach may be tailored. A case vignette illustrates how theories and methods from...

The professional literature has recently given attention to addressing individual schemas in couples relationships, with particular emphasis on the fact that individual vulnerability has a significant impact on couples relationships. This article addresses how this vulnerability can be restructured during the course of couples therapy. Case vignett...