{"id":"https://openalex.org/W7128914224","doi":"https://doi.org/10.7759/cureus.103603","title":"Therapeutic Alliance, Treatment Intensity, and Symptom Change in Post-traumatic Stress Disorder: A Retrospective Study of Eye Movement Desensitization and Reprocessing-Centered Psychotherapy","display_name":"Therapeutic Alliance, Treatment Intensity, and Symptom Change in Post-traumatic Stress Disorder: A Retrospective Study of Eye Movement Desensitization and Reprocessing-Centered Psychotherapy","publication_year":2026,"publication_date":"2026-02-14","ids":{"openalex":"https://openalex.org/W7128914224","doi":"https://doi.org/10.7759/cureus.103603","pmid":"https://pubmed.ncbi.nlm.nih.gov/41846656","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/12991314"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.103603","doi":"https://doi.org/10.7759/cureus.103603","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.103603","pdf_url":"https://www.cureus.com/articles/460144-therapeutic-alliance-treatment-intensity-and-symptom-change-in-post-traumatic-stress-disorder-a-retrospective-study-of-eye-movement-desensitization-and-reprocessing-centered-psychotherapy.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/460144-therapeutic-alliance-treatment-intensity-and-symptom-change-in-post-traumatic-stress-disorder-a-retrospective-study-of-eye-movement-desensitization-and-reprocessing-centered-psychotherapy.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5123510850","display_name":"Ron Gabriel A Peji","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I79905719","display_name":"De La Salle University \u2013 Dasmari\u00f1as","ror":"https://ror.org/03a39dd69","country_code":"PH","type":"education","lineage":["https://openalex.org/I4405258692","https://openalex.org/I79905719"]}],"countries":["PH"],"is_corresponding":true,"raw_author_name":"Ron Gabriel A Peji","raw_affiliation_strings":["Center for Psychotraumatology, Livence Mental Health, Silang, PHL","College of Professional and Graduate Studies, De La Salle University, Dasmari\u00f1as, PHL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Psychotraumatology, Livence Mental Health, Silang, PHL","institution_ids":[]},{"raw_affiliation_string":"College of Professional and Graduate Studies, De La Salle University, Dasmari\u00f1as, PHL","institution_ids":["https://openalex.org/I79905719"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5035422720","display_name":"Jeannie Agustin Perez","orcid":"https://orcid.org/0000-0001-7159-2902","observed_orcids":["https://orcid.org/0000-0001-7159-2902"]},"institutions":[{"id":"https://openalex.org/I79905719","display_name":"De La Salle University \u2013 Dasmari\u00f1as","ror":"https://ror.org/03a39dd69","country_code":"PH","type":"education","lineage":["https://openalex.org/I4405258692","https://openalex.org/I79905719"]}],"countries":["PH"],"is_corresponding":false,"raw_author_name":"Jeannie A Perez","raw_affiliation_strings":["College of Professional and Graduate Studies, De La Salle University, Dasmari\u00f1as, PHL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Professional and Graduate Studies, De La Salle University, Dasmari\u00f1as, PHL","institution_ids":["https://openalex.org/I79905719"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5123510850"],"corresponding_institution_ids":["https://openalex.org/I79905719"],"apc_list":null,"apc_paid":null,"fwci":9.9674,"has_fulltext":true,"cited_by_count":2,"citation_normalized_percentile":{"value":0.96121575,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":95,"max":96},"biblio":{"volume":"18","issue":"2","first_page":"e103603","last_page":"e103603"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10242","display_name":"Posttraumatic Stress Disorder Research","score":0.763700008392334,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10242","display_name":"Posttraumatic Stress Disorder Research","score":0.763700008392334,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10214","display_name":"Psychotherapy Techniques and Applications","score":0.23330000042915344,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T11132","display_name":"Psychoanalysis and Psychopathology Research","score":0.0010999999940395355,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/posttraumatic-stress-disorder","display_name":"post-traumatic stress disorder","score":0.9909999966621399},{"id":"https://openalex.org/keywords/eye-movement-desensitization-and-reprocessing","display_name":"EMDR","score":0.9409999847412109},{"id":"https://openalex.org/keywords/therapeutic-relationship","display_name":"therapeutic relationship","score":0.9990000128746033},{"id":"https://openalex.org/keywords/treatment-intensity","display_name":"treatment intensity","score":0.9990000128746033},{"id":"https://openalex.org/keywords/ptsd-symptom-change","display_name":"PTSD symptom change","score":0.7710000276565552},{"id":"https://openalex.org/keywords/symptom-trajectories","display_name":"symptom trajectories","score":0.7799999713897705},{"id":"https://openalex.org/keywords/outpatient-psychotherapy","display_name":"outpatient psychotherapy","score":0.6520000100135803},{"id":"https://openalex.org/keywords/pcl-5","display_name":"PCL-5","score":0.8989999890327454},{"id":"https://openalex.org/keywords/treatment-moderators","display_name":"treatment moderators","score":0.40700000524520874},{"id":"https://openalex.org/keywords/philippines","display_name":"Philippines","score":0.984000027179718}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7961999773979187},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.6082000136375427},{"id":"https://openalex.org/C2779788018","wikidata":"https://www.wikidata.org/wiki/Q1385716","display_name":"Eye movement desensitization and reprocessing","level":3,"score":0.5253999829292297},{"id":"https://openalex.org/C93225998","wikidata":"https://www.wikidata.org/wiki/Q1941972","display_name":"Moderation","level":2,"score":0.45910000801086426},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.4560000002384186},{"id":"https://openalex.org/C102652120","wikidata":"https://www.wikidata.org/wiki/Q2419430","display_name":"Therapeutic effect","level":2,"score":0.4514000117778778},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.4226999878883362},{"id":"https://openalex.org/C3020110884","wikidata":"https://www.wikidata.org/wiki/Q695416","display_name":"Outpatient clinic","level":2,"score":0.41589999198913574},{"id":"https://openalex.org/C2779779143","wikidata":"https://www.wikidata.org/wiki/Q3493547","display_name":"Desensitization (medicine)","level":3,"score":0.39800000190734863},{"id":"https://openalex.org/C167699689","wikidata":"https://www.wikidata.org/wiki/Q1521337","display_name":"Naturalistic observation","level":2,"score":0.376800000667572},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.34470000863075256},{"id":"https://openalex.org/C2779356329","wikidata":"https://www.wikidata.org/wiki/Q922625","display_name":"Checklist","level":2,"score":0.34049999713897705},{"id":"https://openalex.org/C124306116","wikidata":"https://www.wikidata.org/wiki/Q2512965","display_name":"Ambulatory care","level":3,"score":0.3361999988555908},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.3334999978542328},{"id":"https://openalex.org/C542102704","wikidata":"https://www.wikidata.org/wiki/Q183257","display_name":"Psychotherapist","level":1,"score":0.3249000012874603},{"id":"https://openalex.org/C3017397327","wikidata":"https://www.wikidata.org/wiki/Q1441305","display_name":"Symptom relief","level":2,"score":0.2973000109195709},{"id":"https://openalex.org/C2778633572","wikidata":"https://www.wikidata.org/wiki/Q3424027","display_name":"Therapeutic relationship","level":2,"score":0.28859999775886536},{"id":"https://openalex.org/C2778431023","wikidata":"https://www.wikidata.org/wiki/Q878249","display_name":"Alliance","level":2,"score":0.2818000018596649},{"id":"https://openalex.org/C65409693","wikidata":"https://www.wikidata.org/wiki/Q425265","display_name":"Statistical significance","level":2,"score":0.27320000529289246},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.27300000190734863},{"id":"https://openalex.org/C27081682","wikidata":"https://www.wikidata.org/wiki/Q269829","display_name":"Placebo","level":3,"score":0.2728999853134155},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.2728999853134155},{"id":"https://openalex.org/C129848803","wikidata":"https://www.wikidata.org/wiki/Q2564360","display_name":"Sample size determination","level":2,"score":0.27059999108314514},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.2651999890804291},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.26489999890327454},{"id":"https://openalex.org/C5458421","wikidata":"https://www.wikidata.org/wiki/Q2279219","display_name":"Psychodynamic psychotherapy","level":2,"score":0.2628999948501587},{"id":"https://openalex.org/C2779177272","wikidata":"https://www.wikidata.org/wiki/Q76560","display_name":"Antidepressant","level":3,"score":0.26190000772476196},{"id":"https://openalex.org/C2779477915","wikidata":"https://www.wikidata.org/wiki/Q13693745","display_name":"Cognitive therapy","level":3,"score":0.2563000023365021},{"id":"https://openalex.org/C63363279","wikidata":"https://www.wikidata.org/wiki/Q5133848","display_name":"Clinical significance","level":2,"score":0.25130000710487366}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.103603","doi":"https://doi.org/10.7759/cureus.103603","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.103603","pdf_url":"https://www.cureus.com/articles/460144-therapeutic-alliance-treatment-intensity-and-symptom-change-in-post-traumatic-stress-disorder-a-retrospective-study-of-eye-movement-desensitization-and-reprocessing-centered-psychotherapy.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12991314","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12991314/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12991314/pdf/cureus-0018-00000103603.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"},{"id":"pmid:41846656","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41846656","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.7759/cureus.103603","doi":"https://doi.org/10.7759/cureus.103603","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.103603","pdf_url":"https://www.cureus.com/articles/460144-therapeutic-alliance-treatment-intensity-and-symptom-change-in-post-traumatic-stress-disorder-a-retrospective-study-of-eye-movement-desensitization-and-reprocessing-centered-psychotherapy.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7128914224.pdf","grobid_xml":"https://content.openalex.org/works/W7128914224.grobid-xml"},"referenced_works_count":17,"referenced_works":["https://openalex.org/W1969493492","https://openalex.org/W1997442424","https://openalex.org/W2046463973","https://openalex.org/W2134813353","https://openalex.org/W2174561539","https://openalex.org/W2185349542","https://openalex.org/W2314483685","https://openalex.org/W2611981785","https://openalex.org/W2803499312","https://openalex.org/W2859757904","https://openalex.org/W2994854287","https://openalex.org/W3008045928","https://openalex.org/W3047065905","https://openalex.org/W3180344639","https://openalex.org/W3181358935","https://openalex.org/W4390595347","https://openalex.org/W4406676081"],"related_works":["https://openalex.org/W4413107578","https://openalex.org/W7163668062","https://openalex.org/W1602301795","https://openalex.org/W2069381491","https://openalex.org/W4317952006","https://openalex.org/W7203765420","https://openalex.org/W2012555452","https://openalex.org/W6958349429","https://openalex.org/W2789458230","https://openalex.org/W2323302861"],"abstract_inverted_index":{"Background":[0],"Eye":[1],"movement":[2],"desensitization":[3],"and":[4,32,41,60,93,118,134,163,172,181,203,242,277,297,318,356],"reprocessing":[5],"(EMDR)-centered":[6],"psychotherapy":[7,106,159],"is":[8],"an":[9],"evidence-based":[10],"treatment":[11,33,58,170,298,301,319,332,359],"for":[12,128,176],"post-traumatic":[13],"stress":[14],"disorder":[15],"(PTSD),":[16],"yet":[17],"symptom":[18,62,173,192,213,228,261,324,340],"trajectories":[19],"during":[20],"routine":[21,312],"outpatient":[22,67,110,313],"care":[23],"vary":[24],"considerably.":[25],"Process":[26],"factors":[27],"such":[28],"as":[29,153],"therapeutic":[30,56,295,316],"alliance":[31,137,208,296,317,352],"intensity":[34,150,258,299,320],"may":[35],"influence":[36],"outcomes,":[37],"but":[38,224],"their":[39],"independent":[40,308],"combined":[42],"contributions":[43],"in":[44,64,113,364],"real-world":[45,365],"clinical":[46,78],"settings":[47],"remain":[48],"unclear.":[49],"This":[50,70],"study":[51,74],"examined":[52,166],"the":[53,91,114,125,143,154,345],"relationships":[54],"among":[55],"alliance,":[57,169],"intensity,":[59,171],"PTSD":[61,88,120,126,191,323],"change":[63,214],"a":[65,83,108,349],"naturalistic":[66],"context.":[68],"Methods":[69],"single-center":[71],"retrospective":[72],"cohort":[73],"analyzed":[75],"routinely":[76],"collected":[77],"data":[79],"from":[80,195,263,278],"adults":[81],"with":[82],"clinician-confirmed":[84],"chart":[85],"diagnosis":[86],"of":[87,96,157,347],"based":[89],"on":[90],"Diagnostic":[92],"Statistical":[94],"Manual":[95],"Mental":[97],"Disorders,":[98],"Fifth":[99],"Edition":[100],"(DSM-5)":[101],"criteria":[102],"who":[103],"completed":[104,158],"EMDR-centered":[105,314],"at":[107,131,140,197,201,205],"single":[109],"psychological":[111],"clinic":[112],"Philippines":[115],"between":[116,168,294],"2022":[117],"2025.":[119],"symptoms":[121],"were":[122],"assessed":[123],"using":[124,142],"Checklist":[127],"DSM-5":[129],"(PCL-5)":[130],"baseline,":[132],"mid-therapy,":[133],"post-treatment.":[135,206],"Therapeutic":[136,207],"was":[138,151],"measured":[139],"mid-therapy":[141,202,279],"five-item":[144],"Agnew":[145],"Relationship":[146],"Measure-5":[147],"(ARM-5).":[148],"Treatment":[149,257],"defined":[152],"total":[155],"number":[156],"sessions.":[160],"Linear":[161],"regression":[162],"moderation":[164],"analyses":[165,289],"associations":[167],"change,":[174],"adjusting":[175],"age,":[177],"sex,":[178],"trauma":[179],"type,":[180],"therapy":[182],"type.":[183],"Results":[184],"The":[185],"sample":[186],"included":[187],"138":[188],"patients.":[189],"Mean":[190],"scores":[193],"decreased":[194],"43.7":[196],"baseline":[198,264],"to":[199,216,231,246,265,280,361],"37.8":[200],"30.0":[204],"did":[209],"not":[210],"predict":[211,322],"early":[212,354],"(baseline":[215,230],"mid-therapy;":[217],"\u03b2":[218,233,248],"=":[219,222,234,240,249,255,268,275,283],"-0.01,":[220],"p":[221,236,251,270,285,304],"0.878)":[223],"significantly":[225,259],"predicted":[226,260],"overall":[227],"reduction":[229,262],"post-treatment;":[232,247],"0.61,":[235],"<":[237,252,271,286],"0.001;":[238,253,272],"R\u00b2":[239,254,274],"0.245)":[241],"late-phase":[243],"improvement":[244],"(mid-therapy":[245],"0.62,":[250],"0.207).":[256],"post-treatment":[266,281],"(\u03b2":[267,282],"-0.21,":[269],"adjusted":[273],"0.251)":[276],"-0.26,":[284],"0.001).":[287],"Moderation":[288],"showed":[290],"no":[291],"significant":[292],"interaction":[293],"across":[300],"phases":[302],"(all":[303],">":[305],"0.10),":[306],"indicating":[307],"effects.":[309],"Conclusions":[310],"In":[311],"psychotherapy,":[315],"independently":[321],"improvement.":[325],"Alliance":[326],"appears":[327],"most":[328],"consequential":[329],"after":[330],"initial":[331],"engagement,":[333],"while":[334],"greater":[335],"session":[336],"completion":[337],"supports":[338],"sustained":[339],"reduction.":[341],"These":[342],"findings":[343],"underscore":[344],"importance":[346],"fostering":[348],"strong":[350],"working":[351],"beyond":[353],"sessions":[355],"promoting":[357],"adequate":[358],"exposure":[360],"optimize":[362],"outcomes":[363],"trauma-focused":[366],"care.":[367]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-02-15T00:00:00"}