Early development of mechanisms of change as a predictor of subsequent change and treatment outcome: The case of working alliance.
نویسندگان
چکیده
OBJECTIVE Advanced statistical tools have created the opportunity to systematically examine the effect of early trajectories in predictors of therapeutic change, such as early alliance development patterns, on outcome. To date, however, these methods have been used almost exclusively to examine the effect of the development of early symptoms on later ones. Development patterns of alliance early in treatment, and their association with treatment outcome, have received much theoretical attention, but few systematic examinations have been conducted so far. METHOD We integrated exploratory cluster analysis with the accumulated theoretical and empirical knowledge on patterns of alliance development to identify distinct patterns of early alliance development across the 1st 4 sessions of treatment in a sample of 166 patients receiving psychotherapy. RESULTS Three patterns of early alliance development were identified: early gradual strengthening, early repaired rupture, and early unrepaired rupture. The gradual strengthening and the repaired rupture patterns early in treatment predicted alliance strengthening later in treatment, whereas the unrepaired rupture pattern early in treatment predicted alliance stability later in treatment. The effect of early alliance development patterns on treatment outcome was moderated by pretreatment interpersonal problems: For patients with better interpersonal functioning at intake, the gradual strengthening and the repaired rupture patterns showed better outcomes, whereas for those with poorer interpersonal functioning at intake, the early unrepaired rupture pattern showed better outcomes. CONCLUSIONS Findings suggest that early alliance development patterns affect treatment process and outcome. (PsycINFO Database Record
منابع مشابه
When is it Effective to Focus on the Alliance? Analysis of a Within-Client Moderator
concerns the working alliance, commonly defined as the emotional bond established in the therapeutic dyad, and the agreement between client and therapist concerning the goals of therapy and the tasks required to achieve them (Bordin 1979; Hatcher and Barends 2006). The strength of the working alliance is a consistent predictor of outcome in psychotherapy, with stronger alliance predicting bette...
متن کاملThe impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders.
The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of ...
متن کاملThe relationship between the therapeutic alliance and treatment outcome in two distinct psychotherapies for chronic depression.
OBJECTIVE This study tested whether the quality of the patient-rated working alliance, measured early in treatment, predicted subsequent symptom reduction in chronically depressed patients. Secondarily, the study assessed whether the relationship between early alliance and response to treatment differed between patients receiving cognitive behavioral analysis system of psychotherapy (CBASP) vs....
متن کاملPersonality, interpersonal, and motivational predictors of the working alliance in group cognitive-behavioral therapy for partner violent men.
Recent studies have demonstrated that the working alliance predicts treatment outcome for partner violent men. This study examined the influence of personality and interpersonal characteristics, motivational readiness to change, and demographic factors on working alliance formation among a sample of men (N = 107) participating in a cognitive-behavioral group treatment program for partner violen...
متن کاملThe Effect of Health Transform Plan on Satisfaction of Waiting Time and Continuation of Receiving Maternal Health Services in Clients of Community Health Centers of Iran University of Medical Sciences
Background: Fertility care, pre-pregnancy, pregnancy period and postpartum care play a very important role in the early diagnosis and timely and effective treatment of pregnancy and postpartum complications. This study was conducted to assess the effect of health transform plan on satisfaction of waiting time and continuation of receiving maternal health services in clients of community health ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of consulting and clinical psychology
دوره 85 5 شماره
صفحات -
تاریخ انتشار 2017