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The interaction of the alliance and therapy microprocess: a sequential analysis

H C Sexton¹, K Hembre, G Kvarme

¹Psychiatric Research Center, Asgård Hospital, Tromsø Norway.

Journal of Consulting and Clinical Psychology

|June 1, 1996

Summary

The working alliance, crucial for therapy success, forms early and influences session dynamics. A strong alliance leads to better patient engagement and distinct therapeutic processes.

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Area of Science:

Psychology
Psychotherapy Research
Clinical Psychology

Background:

The working alliance is a key factor in psychotherapy outcomes.
Understanding its interplay with in-session processes is vital for therapeutic change.

Purpose of the Study:

To explore the interaction between the working alliance and therapy microprocesses in brief therapy.
To identify how alliance development influences specific therapeutic activities, emotions, and content.

Main Methods:

Sequential analytic study design.
Involved 32 participants in brief therapy.
Utilized log-linear modeling to analyze alliance-related effects on microprocesses.

Main Results:

The working alliance formed early, primarily in the first session, and correlated with mutual emotional engagement.
Alliance strength significantly impacted therapy microprocesses, including activities, topics, emotions, and verbal content.
High-alliance therapies showed distinct patterns, with patients exhibiting greater emotional engagement and less dejection.

Conclusions:

Therapeutic change may be influenced by the differential development of high- and low-alliance therapies.
The findings suggest considering alliance-specific trajectories in theories of therapeutic change.
Early alliance formation and its phase-specific effects on microprocesses are critical.