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Working alliance predicts psychotherapy outcome even while controlling for prior symptom improvement
Centre for Clinical Research Sörmland, Uppsala University, Sweden.
Centre for Clinical Research Sörmland, Uppsala University, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
2014 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 24, no 2, 146-159 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Although the working alliance as been found to be a robust predictor of psychotherapy outcome, critics have questioned the causal status of this effect. Specifically, the effect of the alliance may be confounded with the effect of prior symptom improvement. The objective of the present study was to test this possibility. Method: A large dataset from primary care psychotherapy was used to study relationships between alliance and outcome using piecewise multilevel path analysis. Results: Initial symptom level and symptom change up to session three predicted the alliance at session three. Working alliance significantly predicted symptom change rate from session three to termination, even while controlling for several possible confounds. Conclusions: 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.

Place, publisher, year, edition, pages
Routledge, 2014. Vol. 24, no 2, 146-159 p.
Keyword [en]
working alliance; psychotherapy outcome; therapy process; multilevel modeling; path analysis
National Category
Social Sciences
URN: urn:nbn:se:liu:diva-105033DOI: 10.1080/10503307.2013.847985ISI: 000330690800003PubMedID: 24188079ScopusID: 2-s2.0-84893724810OAI: diva2:703384
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2015-03-30Bibliographically approved

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