Predicting treatment process and outcome using temporal dynamics of supervisory working alliance

This study examined the temporal dynamics of supervisor- and supervisee-rated supervisory working alliance (SWA) and their relations to treatment process and outcome.

The sample included 28 supervisory dyads participating in a total of 1709 weekly supervision sessions and rating SWA at each session. Meanwhile, 261 community clients attended psychotherapy with the supervisees, providing session evaluation and alliance ratings at each session and the Outcome Questionnaire-45 (OQ) every eighth session. We used a longitudinal actor partner interdependence model. Responsiveness was operationalized as the paths from one partner's SWA to the other partner's SWA in the following week. In-phase responsiveness is a positive path, where dyadic SWA perceptions change in the same direction. Anti-phase responsiveness is a negative path, indicating that dyadic SWA perceptions fluctuate around an equilibrium. SWA rupture and repair was operationalized as SWA variability.

Clients had greater OQ improvement when the supervisory dyads exhibited greater anti-phase responsiveness. Clients had higher session evaluation and greater OQ improvement when the supervisory dyads had greater SWA variability.

Supervisors who maintain a dynamic equilibrium in response to their supervisees' SWA changes may help offer a constructive consultant perspective. SWA variability may reflect in-depth work.