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J Consult Clin Psychol ; 64(3): 471-80, 1996 Jun.
Article in English | MEDLINE | ID: mdl-8698939

ABSTRACT

The interaction of the working alliance with the therapy microprocess was explored in a sequential analytic study of brief therapy (N = 32). The alliance was largely formed within the first session and was most associated with a mutual emotional engagement process. Thereafter, log-linear modeling revealed marked alliance-related and primarily phase-specific effects on the therapy microprocesses. The alliance was associated with differing patterns of therapy activities, topics, emotions, and verbal content. High-alliance midtherapy displayed more of an alternating pattern of therapist-patient emotional engagement, although therapists also appeared to take greater charge in midtherapy. High-alliance patients were generally more emotionally engaged and responded with less dejection to therapists. The alliance-dependent differences in verbal content appeared to be secondary, with the most obvious negative effects of low-alliance levels appearing in midtherapy. Apparently, the high- and low-alliance therapies developed somewhat differently, a factor that may need to be considered in constructing theories of therapeutic change.


Subject(s)
Anxiety Disorders/therapy , Depressive Disorder/therapy , Outcome and Process Assessment, Health Care , Professional-Patient Relations , Psychotherapy/methods , Adult , Anxiety Disorders/psychology , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Personality Assessment , Psychoanalytic Therapy/methods , Psychotherapy, Brief/methods
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