A Longitudinal Analysis of Factors Associated with Therapeutic Alliances

Community Ment Health J. 2018 Aug;54(6):782-792. doi: 10.1007/s10597-017-0229-1. Epub 2018 Jan 9.

Abstract

This study examined the impact, on therapeutic alliances, made by client motivation to change, insight, mistrust, and other factors; as well as therapist's clinical experience. This secondary data analysis used a sample of 212 client respondents extracted from the Treatment of Depression Collaborative Research Program's data set. Results of generalized least squares random-effects modeling showed a significant impact exerted by client social-adjustment difficulties, insight, alcohol use, and gender; and client-therapist matching gender. Also, four elements of therapeutic alliances-regard, empathic understanding, unconditionality, and congruence-had four unique patterns of significant factors. To foster therapeutic alliances, therapists need to help clients develop awareness of and insight into the clients' social-adjustment difficulties; therapists should also be particularly sensitive to expectations of clients of the opposite sex. Implications for future research are suggested.

Keywords: Insight; Motivation; Working alliance.

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology
  • Cognitive Behavioral Therapy
  • Databases, Factual
  • Depression / psychology*
  • Depression / therapy*
  • Empathy
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Marijuana Smoking / epidemiology
  • Middle Aged
  • Motivation*
  • Multivariate Analysis
  • National Institute of Mental Health (U.S.)
  • Social Adjustment*
  • Surveys and Questionnaires
  • Therapeutic Alliance*
  • United States / epidemiology