A relational perspective on the association between working alliance and treatment outcome

Psychotherapy Research : Journal of the Society for Psychotherapy Research
Carl-Johan UckelstamFredrik Falkenström

Abstract

Objective: Evidence is inconclusive on whether variability in alliance ratings within or between therapists is a better predictor of treatment outcome. The objective of the present study was to explore between and within patient and therapist variability in alliance ratings, reciprocity among them, and their significance for treatment outcome. Method: A large primary care psychotherapy sample was used. Patient and therapist ratings of the working alliance at session three and patient ratings of psychological distress pre-post were used for analyses. A one-with-many analytical design was used in order to address problems associated with nonindependence. Results: Within-therapist variation in alliance ratings accounted for larger shares of the total variance than between-therapist variation in both therapist and patient ratings. Associations between averaged patient and therapist ratings of the alliance for the individual therapists and their average treatment outcome were weak but the associations between specific alliance ratings and treatment outcome within therapies were strong. Conclusions: The results indicated a substantial dyadic reciprocity in alliance ratings. Within-therapist variation in alliance was a better predicto...Continue Reading

References

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Citations

Jun 3, 2020·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Fredrik FalkenströmJulian A Rubel
Dec 31, 2020·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Orya Tishby, Hadas Wiseman
Mar 24, 2021·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Ora NakashMargarita Alegría

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Software Mentioned

Statistical Package for the Social Sciences ( SPSS

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