Changes in meaning in life, working alliance, and outcome in psychodynamic psychotherapy: What leads to what?

Abstract

We examined how meaning in life was associated with working alliance (WA) and outcomes, all from the client perspective. Random intercept lagged cross-panel analyses were used to analyze data from intake and after every eight sessions for the first 24 sessions of open-ended individual psychodynamic psychotherapy from 94 clients nested within 12 therapists. We found that, for all four time periods, working alliance in one 8-week time period predicted both Meaning in Life Measure-Experience (MILM-E) and Meaning in Life Measure-Reflectivity (MILM-R) in the subsequent time period, and MILM-R in one 8-week time period predicted client outcome in the subsequent time period. These findings suggest that having a strong working alliance is associated with clients developing more meaning in life, and reflectivity about meaning in life is associated with clients improving in psychotherapy. Implications for practice and research are discussed. Public Significance StatementHaving a good working alliance seems to help clients experience and reflect on meaning in life. Furthermore, reflecting deeply about meaning in life seems to lead to changes in psychological functioning in individual psychotherapy. Thus, it behooves therapists to help clients reflect about meaning in life once they have established a good therapeutic relationship.

Penerapan Konseling Akademik untuk Meningkatkan Motivasi Berprestasi Siswa SMA di Jakarta

“…Bahkan, ada saja kasus bunuh diri yang dilakukan oleh seorang pelajar atau mahasiswa karena mereka tidak mengetahui bagaimana menghadapi masalah pribadinya tersebut. Ia merasa kehilangan energi dan juga kehilangan harapan untuk hidup (Rim, Hill, & Kivlighan, 2022). Akhirnya, dapat saja muncul gagasan bunuh diri.…”