The therapeutic alliance in different mental disorders: A comparison of patients with depression, somatoform, and eating disorders

Abstract

We found no differences in the strengths of alliance ratings and alliance-outcome associations in depressive, somatoform, and eating disorder patients. This indicates that the working alliance is of general clinical importance irrespective of the disorder group and should be a central target in all therapies. We found perspective incongruence in alliance ratings between patient and therapist in all three disorder groups. Perspective incongruence feedback of working alliance experiences could help to strengthen coordination between patient and therapist and thereby improve the therapeutic process.

Mindfulness and progressive muscle relaxation as standardized session‐introduction in individual therapy: A randomized controlled trial

“…Meta‐analyses identified a significant overall alliance–outcome relation of r = 0.27 that is ubiquitous, irrespective of treatment type, rater perspective, time of alliance assessment, or outcome measure (Flückiger, Del re, Wampold, Symonds, & Horvath, ; Horvath et al, ). Of note, none of the moderators in these meta‐analyses were experimentally manipulated variables; therefore, causal statements are not warranted (Flückiger et al, ; Mander et al, ). Thus, our results add to the robust effect of the therapeutic alliance irrespective of moderating variables, even experimentally manipulated variables that theoretically should result in beneficial alliance effects.…”

Therapeutic alliance in inpatients with severe anorexia nervosa

“…The concept of TA has been long called into question in the treatment of a whole variety of disorders (Mander et al, ), mostly with respect to psychotherapy interventions (Del Re, Flückiger, Horvath, Symonds, & Wampold, ; Horvath, Del Re, Flückiger, & Symonds, ; Taylor, Rietzschel, Danquah, & Berry, ; Zaitsoff et al, ) with several studies showing that multiple psychotherapy approaches lead to comparable positive effects. In this regard, it would be of interest to investigate more the common factors in the field of psychotherapy, as authoritatively stated (Wampold, ).…”

“…Nevertheless, little data exist so far in AN because TA has been only sparsely investigated in this field (Zaitsoff et al, ) and the majority of data derive from outpatients receiving psychotherapy. Adults and adolescents with eating disorders have been found to establish effective TA, also when compared with individuals affected by different mental disorders (Mander et al, ). However, differently from other fields of psychiatry where TA proved to predict about 5% of the clinical improvement (Horvath & Symonds, ; Martin, Garske, & Davis, ), the role of TA in treatment outcome of patients with eating disorders is more debated (Brauhardt, de Zwaan, & Hilbert, ; Zaitsoff et al, ).…”

“…Very limited research is available also on TA in patients with severe and enduring AN (SE‐AN); a study reported that also those with a longer duration of illness (e.g., ≥7 years) can establish a solid TA, which can in turn influence clinical outcome with respect to both eating and depressive symptoms (Stiles‐Shields et al, ). Also, it has been suggested that motivation for change is relevant in fostering TA for those affected by an enduring disorder (Mander et al, ).…”

Proposta para análise da psicoterapia pais-bebê: evidências de dois casos

“…Uma das questões relevantes da proposta metodológica apresentada neste artigo refere-se à tentativa de avaliar os fatores específicos de mudança em PPB. Comumente as pesquisas em psicoterapia apontam que são os fatores inespecíficos que têm aparecido associados com mudanças positivas ao longo do processo terapêutico (Mander et al, 2017;Björnsson, 2015;Tschuschke et al, 2015) e, dentre estes, o que tem sido destacado com mais frequência se refere à interação paciente e terapeuta. Com isto, alguns autores tem enfatizado que é a qualidade da relação terapêutica o fator crucial de mudança, e menos importância é dada para fatores específicos da técnica.…”