Working alliance predicts psychotherapy outcome even while controlling for prior symptom improvement

Abstract

The alliance predicts outcome over and above the effect of prior symptom improvement, supporting a reciprocal influence model of the relationship between alliance and symptom change.

Reciprocal influence model of working alliance and therapeutic outcome over individual therapy course.

“…There have been a limited number of studies examining the link of alliance-symptom change while taking into consideration the temporal sequence (Barber, 2009;Falkenström et al, 2014;Zilcha-Mano et al, 2014). However, the previous longitudinal reciprocal research (e.g., (Falkenström et al, 2014) investigating the effect of the working alliance typically Reciprocal Model of Working Alliance and Therapeutic Outcome 7 adopted a single alliance rating at the third session.…”

“…While the previous research has consistently demonstrated the prediction of the working alliance on the therapeutic outcome (Horvath et al, 2011;Lambert & Barley, 2001), the mechanism of this effect is continuously being questioned and investigated (e.g., (Falkenström, Granström, & Holmqvist, 2014;Tasca & Lampard, 2012). Norcross and Lambert (2014) commented that psychotherapy professionals could oversimplify the nature of therapy and exaggerate the impact of the working alliance when only seeing the prominent legacy of the unidirectional alliance-outcome research.…”

“…However, the previous longitudinal reciprocal research (e.g., (Falkenström et al, 2014) investigating the effect of the working alliance typically Reciprocal Model of Working Alliance and Therapeutic Outcome 7 adopted a single alliance rating at the third session. Such an approach fails to recognize the change of the working alliance over time (Kivlighan & Shaughnessy, 2000;Kivlighan & Shaughnessy, 1995;Stiles et al, 2004) and ignores the enhancement of the working alliance-outcome link over time (Flückiger, Del Re, Wampold, Symonds, & Horvath, 2012;Martin et al, 2000).…”

“…They found that prior change in urge to restrict food intake predicted the subsequent change in alliance to the group, based on weekly assessment of both constructs. Falkenström et al (2014) examined the prediction of the prior symptom changes up to session three on the working alliance at the third session. Results supported that the prior symptom changes predicted the working alliance over and beyond the initial symptoms.…”

Caso Vera: intervenções do psicoterapeuta e aliança terapêutica

“…Para Martin, Garske e Davis (2000) esta variação conceitual é decorrente das diferentes edifi cações teóricas existentes na psicologia. Contudo, todas as abordagens ressaltam a importância da aliança terapêutica no processo psicoterápico, e entende-se que uma vez estabelecida pode gerar resultados favoráveis ao processo (Falkenström, Granström, & Homqvist, 2014;Luborsky, 2000;Yoshida & Enéas, 2013).…”