Objective: To examine the associations between treatment/outcome expectations, alliance before and during treatment, and the impact of alliance on symptomatic improvement. Methods: One hundred and fifty-three depressed patients randomized to dynamic supportive-expressive psychotherapy (SET), antidepressant medication (ADM) or placebo (PBO) + clinical management completed ratings of treatment expectations, therapeutic alliance (CALPAS, WAI-S), and depressive symptoms (HAM-D). Results: Pretreatment expectations of the therapeutic alliance were significantly related to alliance later in therapy but did not differ across treatments and did not predict outcome. Alliance development over time differed between treatments; it increased more in SET than in PBO. After controlling for prior symptom improvement, early alliance predicted subsequent depression change. Conclusions: Expectations of alliance and of treatment outcome/improvement, measured prior to treatment onset, predicted subsequent alliance.
Bibliographical noteFunding Information:
The original study was funded by a NIMH grant R01 MH 061410 to Jacques P. Barber. The sertraline and placebo pills were provided by a grant from Pfizer Corp. Neither sponsor had any role in the study besides funding the study (NIMH) or supplying the sertraline and placebo pills (Pfizer).
- psychodynamic psychotherapy
ASJC Scopus subject areas
- Clinical Psychology