Grant: Master's Award: Canada Graduate Scholarships

How Does In-Session Resistance Impact Treatment Outcomes?Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) together cost Canadians over $62.8 billion annually. The co-occurrence of these two disorders is associated with lower levels of treatment engagement and substantially higher treatment dropout rates. Yet, few studies have examined moderators of treatment outcome and dropout in PTSD/SUD psychotherapy. This study will be the first to examine resistance among individuals with these co-occurring disorders. Resistance, defined as any behaviour that opposes or blocks the direction set by the therapist, has been identified as a strong predictor of poorer treatment outcomes and associated with early withdrawal of treatment. Resistance has been found to be particularly problematic in directive treatments such as cognitive-behavioural therapy (CBT), a treatment approach often used to address both PTSD and SUD. The proposed hypotheses are 1) greater resistance will be associated with poorer PTSD symptom reduction at post-treatment and 3-month follow-up; 2) greater resistance will be associated with poorer SUD symptom reduction at post-treatment and 3-month follow-up; and 3) greater resistance will be associated with higher rates of dropout. The results of this study will further the understanding of mechanisms within psychotherapy which will subsequently help enhance treatment outcomes and improve healthcare.