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The therapeutic alliance in psychodynamic-interpersonal and cognitive-behavioral therapy.
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Abstract
The quality of the therapeutic alliance was compared in sessions of psychodynamic-interpersonal
and cognitive-behavioral therapy, and the alliance's relationship to various session
impacts was investigated. As part of the Sheffield Psychotherapy Project 2 (D. A.
Shapiro, M. Barkham, A. Rees, G. E. Hardy, S. Reynolds, & M. Startup, 1994), 57 clients
diagnosed with major depression received 16 sessions of either psychodynamic-interpersonal
or cognitive-behavioral therapy. Coders used the Working Alliance Inventory to rate
1 high-impact and 1 low-impact session from each client. Results indicated significantly
greater alliance scores for cognitive-behavioral therapy sessions on the whole. Also,
for the samples as a whole, high-impact sessions were characterized by higher alliance
scores than those for low-impact sessions, and alliance was positively related to
therapists' ratings of session depth and smoothness and to clients' ratings of mood.