Convergence in patient-therapist therapeutic alliance ratings and its relation to outcome in chronic depression treatment. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: This study tested whether discrepancy between patients' and therapists' ratings of the therapeutic alliance, as well as convergence in their alliance ratings over time, predicted outcome in chronic depression treatment. METHOD: Data derived from a controlled trial of partial or non-responders to open-label pharmacotherapy subsequently randomized to 12 weeks of algorithm-driven pharmacotherapy alone or pharmacotherapy plus psychotherapy. The current study focused on the psychotherapy conditions (N = 357). Dyadic multilevel modeling was used to assess alliance discrepancy and alliance convergence over time as predictors of two depression measures: one pharmacotherapist-rated (Quick Inventory of Depressive Symptoms-Clinician; QIDS-C), the other blind interviewer-rated (Hamilton Rating Scale for Depression; HAMD). RESULTS: Patients' and therapists' alliance ratings became more similar, or convergent, over the course of psychotherapy. Higher alliance convergence was associated with greater reductions in QIDS-C depression across psychotherapy. Alliance convergence was not significantly associated with declines in HAMD depression; however, greater alliance convergence was related to lower HAMD scores at 3-month follow-up. CONCLUSIONS: The results partially support the hypothesis that increasing patient-therapist consensus on alliance quality during psychotherapy may improve treatment and longer term outcomes.

publication date

  • February 1, 2016

Research

keywords

  • Depressive Disorder
  • Outcome and Process Assessment, Health Care
  • Professional-Patient Relations
  • Psychotherapy

Identity

PubMed Central ID

  • PMC4969229

Scopus Document Identifier

  • 84958549443

Digital Object Identifier (DOI)

  • 10.1037/a0023252

PubMed ID

  • 26829714

Additional Document Info

volume

  • 27

issue

  • 4