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Working alliance predicts psychotherapy outcome even while controlling for prior symptom improvement
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
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
2014. Vol. 24, no 2, 146-159 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-220275DOI: 10.1080/10503307.2013.847985ISI: 000330690800003PubMedID: 24188079OAI: oai:DiVA.org:uu-220275DiVA: diva2:706377
Available from: 2014-03-20 Created: 2014-03-12 Last updated: 2017-12-05Bibliographically approved

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