The relationship between patient factors and therapeutic alliance in CBT and IPT for depression.

Type of content
Theses / Dissertations
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Thesis discipline
Psychology
Degree name
Master of Arts
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Journal Title
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Volume Title
Language
English
Date
2002
Authors
Robinson, Celia F.
Abstract

The therapeutic relationship between a patient and therapist in psychotherapy, known as the therapeutic alliance, has received increasing empirical attention in recent decades. One reason for this may be that empirical findings have shown that the quality of the therapeutic alliance contributes to the magnitude of therapeutic outcome. Despite this focus on the relationship between alliance and outcome, specific factors influencing the quality of the therapeutic alliance, particularly the influence of patient characteristics, have not yet been clearly established. The function of the alliance differs across psychotherapy modalities, although most types of psychotherapy stress, to varying degrees, the importance of a positive therapeutic alliance. The majority of empirical studies have shown similar levels of therapeutic alliance across therapy types, although a few studies have shown differing levels. The present study examined the relationship between specific patient factors and the level of therapeutic alliance formed in one early session of cognitive behavioural therapy (CBT) or interpersonal psychotherapy (IPT), for depression. Participants in this study were a sample of depressed outpatients (N = 42) drawn from participants in a larger clinical outcome trial, the Psychotherapy for Depression Study. The quality of the alliance was measured by observer ratings of audiotaped therapy sessions, using the Vanderbilt Therapeutic Alliance Scale (VTAS). The patient characteristics investigated in this study were: gender; severity, chronicity and recurrence of depression; age of onset of first depressive episode; and presence of personality disorder symptoms and diagnoses. In addition, the level of therapeutic alliance was compared across the two psychotherapies used in the Psychotherapy for Depression Study. The following patient factors were significantly associated with the level of alliance formed: depression severity; depression chronicity; gender; and certain aspects of personality dysfunction. The level of alliance was not significantly different across therapy types. Some of these results were consistent with other findings in the alliance literature. Reasons for these findings are discussed, as well as clinical implications of the resultsĀ·and future research possibilities.

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