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Updated: May 6, 2026

Functional Near-Infrared Spectroscopy Hyperscanning Study in Psychological Counseling
Published on: January 17, 2025
Negative, not positive symptoms predict the early therapeutic alliance in cognitive behavioral therapy for psychosis
Esther Jung1, Martin Wiesjahn, Tania M Lincoln
1a Section for Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-Universität Marburg , Marburg , Germany.
Objective:
The strength of therapeutic alliance is consistently associated with therapy outcome. The aim of this study was to identify relevant predictors for early therapeutic alliance in cognitive behavioral therapy for psychosis.
Method:
Fifty-six patients with schizophrenia spectrum disorders were included in the analysis. Possible predictors (positive and negative symptoms, depression, insight, social functioning, theory of mind, and medication adherence) were assessed at baseline. Alliance was assessed after each therapy session.
Results:
Lower negative symptoms significantly predicted higher patient and therapist rated alliance.
Conclusions:
The findings indicate that negative symptoms might be a barrier to the development of therapeutic alliance. Assumed underlying processes and practical implications are discussed.
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