Stages of change and the working alliance in psychotherapy

Abstract

This study investigated whether the working alliance mediates between the stages of change and symptom improvement. It also investigated whether progression to a higher stage of change was associated with an enhancement in working alliance and outcome scores. Fifty-six adult clients receiving counseling at a community mental health clinic completed measures after the first, fifth, and termination sessions. Using the Baron and Kenny (1986) and bootstrapping procedures, the working alliance was found to be a mediating variable. A multivariate analysis of variance indicated that clients who progressed from a lower stage to a higher stage reported stronger working alliances and more symptom improvement than those who did not progress. These results offer further support for the importance of a strong working alliance in psychotherapy.

Patterns of Change in Collaboration Are Associated with Baseline Characteristics and Predict Outcome and Dropout Rates in Treatment of Multi-Problem Families. A Validation Study

“…The third group of technical factors adds such factors as the level of therapist directedness, treatment intensity (length, frequency, multi-modal, etc.). The therapeutic change that is accomplished by the interaction of these three therapeutically relevant groups has been shown to often run discontinuously through different “stages of change” (preparation, action, maintenance, contemplation, action) (Emmerling and Whelton, 2009; Schiepek et al, 2015). The crucial step is from “contemplation to action,” i.e., to “collaboration.”…”

Mudança em pacientes de clínica-escola: avaliação de resultados e processos

“…Among the dimensions of change of the Transtheoretical Model, the stage of change is the one that is more applicable to clinical practice and research (Emmerling & Whelton, 2009). However, to comprehend the factors involved in the progress of the patient, or lack thereof, the other two dimensions, processes and levels of change, must also be considered (Prochaska, 1995).…”

“…The change occurs, usually through a spiral motion, in which relapses and returns to the old patterns of behavior are expected. This means that with every reversal, the patient can learn from their mistakes and try something different next time (Emmerling & Whelton, 2009;Prochaska, 1995). The third dimension is the levels of change, related to the extent and depth of the changes achieved or targeted in the psychotherapy.…”

Mudança em psicoterapia: indicadores genéricos e eficácia adaptativa

“…Inúmeras pesquisas ressaltam a importância de uma boa relação de trabalho entre psicoterapeuta e paciente, pois confiança e compromisso mútuos possibilitam uma aliança de trabalho positiva e há fortes evidências de que esta pode desempenhar um papel crucial nos resultados das psicoterapias (Botella et al, 2008;Emmerling & Whelton, 2009;Hill & Knox, 2009;Honda & Yoshida, 2012;Lhullier et al, 2006). Aliança de trabalho ou aliança terapêutica parece ser, portanto, um componente chave nas psicoterapias e embora não seja curativa por si só, é considerada como um dos melhores preditores nos tratamentos psicoterápicos (Binder, Holgersen, & Nielsen, 2009;Krause et al, 2011;Santibáñez-Fernández, Román-Mella, & Vinet, 2009;Salinas et al, 2009;Serralta, Pole, Nunes, Eizirik, & Oslen, 2010).…”