The effect of personality and personality disorders on therapeutic alliance in the treatment of depression (2019)
Type of ContentTheses / Dissertations
Degree NameMaster of Science
PublisherUniversity of Canterbury
The therapeutic alliance has been identified as the most consistent predictor of psychotherapy outcome. Therapeutic alliance is an interpersonal relationship between client and therapist. Interpersonal relationships can be influence by personality disorders as personality disorders affect how individuals form attachments and behave in relationships and are expected to disrupt the formation and maintenance of interpersonal relationships. Therefore, it is to be expected that personality disorders will have an influence on the formation and maintenance of the therapeutic alliance.
Limited research has investigated the extent to which client personality factors contribute to the quality and strength of the therapeutic alliance. To investigate potential predictors of the therapeutic alliance, associations between measures of personality pathology in a population of outpatients receiving psychotherapy for major depressive disorder (n = 99) and observer-ratings of audio recordings of therapy sessions were examined.
Pre-treatment assessments of temperament and character traits as measured by Cloninger’s Temperament and Character Inventory and clinical characteristics of personality disorders as indicated by the SCID-II assessment were examined as predictors of the Revised version of the Vanderbilt Therapeutic Alliance Scale and Vanderbilt Psychotherapy Process Scale subscales.
Results of the current study found that Cluster C personality disorder diagnoses and the TCI-R character component of self-transcendence were found to positively predict the therapeutic alliance. Cluster A personality disorder symptoms, Cluster C personality disorder symptoms, and the TCI-R temperament component of novelty seeking were predictive of poor therapeutic alliance. These findings emphasise the importance of understanding clients’ pre-treatment personality pathology so therapists can tailor psychotherapy to clients’ individual needs facilitating better engagement during the treatment process.
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