The therapeutic alliance in psychodynamic psychotherapy: Theoretical conceptualizations and research findings.

Abstract

The construct of the therapeutic alliance is approached from the psychoanalytic tradition by reference to the ideas of Freud, Sterba, Zetzel, Greenson, and Luborsky. The transtheoretical approaches posited by Bordin and Gaston are also presented and the relation of alliance to the transference is discussed. The empirical evidence as to the role of the alliance in psychodynamically oriented psychotherapy is presented, and the construct is operationally defined by means of the major psychometric instruments. Factors that foster the development of strong alliances (patient and therapist factors), as well as those that hinder or result in its rupture are discussed in detail. The differential association of alliance to outcome depending on who measures the alliance

A review and critical appraisal of measures of therapist-patient interactions in mental health settings

“…28,81,82 Such ruptures in therapy are common and an expected part of treatment. 28,75,77,83 Crits-Christoph 84 describes ruptures as transference reactions; others when the therapist makes mistakes, is anxious or has a strong need for approval, or when patients experience negative feelings about the therapist as a result of the therapist doing something they did not want, or not doing something they did want.…”

“…96 This is referred to as the alliance (working, therapeutic, etc.). Although there are important differences in the definitions of the alliance, 26 for example, a major controversy exists whether the alliance arises from the interpersonal process or is an intrapsychic phenomenon 82 and different therapies will emphasise different aspects of the alliance, it is the quality and strength of the collaborative relationship between patient and therapist that appears important. 45 The most frequently used definition of the alliance is by Bordin,48 who describes three elements of the relationship: consensus with regard to task; affective bond (trust, liking, caring); and agreement on goals (actively committed, purposeful).…”

“…55 In contrast, some therapies attribute the competence of the therapist to the authority and respect they command. 28,67,76,82,91,92,103,124,126 The expert role is linked theoretically to social influence theory, and the value of being seen as the expert is that it helps to build clients' expectancies. 73 This aspect of the therapist's role is put forward as being the route through which computer and Internet therapies achieve success.…”

Relation entre l'alliance thérapeutique, la santé mentale ainsi que la satisfaction envers la thérapie au cours d'un processus psychothérapeutique chez l'adulte /

“…La présence d'un lien affectif entre le client et le thérapeute est aussi une composante de l'alliance thérapeutique fréquemment rencontrée dans les écrits (DeRoten, Gilliéron, Despland, & Stigler, 2002;Freud, 1912Freud, /1966Hatcher et al, 1996;Horvath, 2000;Safran & Muran, 1996;Zetzel, 1956 (Bordin, 1979;Goudreau et al, 2001;Horvath, 2001;Kozart, 2002;Saketopoulou, 1999 (Goudreau et al, 2001). …”

“…D'autres encore ont fait uniquement une recension des définitions de l'alliance thérapeutique existantes (Bachelor et al, 1999;Saketopoulou, 1999;Waddington, 2002 …”