Interaction among Alliance, Psychodynamic–Interpersonal and Cognitive–Behavioural Techniques in the Prediction of Post-session Change
Article first published online: 24 APR 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Clinical Psychology & Psychotherapy
Volume 20, Issue 6, pages 513–522, November-December 2013
How to Cite
Owen, J., Hilsenroth, M. J. and Rodolfa, E. (2013), Interaction among Alliance, Psychodynamic–Interpersonal and Cognitive–Behavioural Techniques in the Prediction of Post-session Change. Clin. Psychol. Psychother., 20: 513–522. doi: 10.1002/cpp.1792
- Issue published online: 3 DEC 2013
- Article first published online: 24 APR 2012
- Manuscript Accepted: 23 MAR 2012
- Manuscript Revised: 21 MAR 2012
- Manuscript Received: 27 SEP 2011
- Post-session Change
The current study examined the interaction of clients' perceptions of the psychodynamic–interpersonal (PI) and cognitive–behavioural (CB) techniques that their therapist utilized in their most recent therapy session and working alliance in the prediction of post-session changes. Seventy-five clients were treated by 25 therapists at a counselling centre in the USA. We posited that alliance would interact with clients' perceptions of their therapists' use of PI and CB techniques in the prediction of post-session changes. The results revealed a three-way interaction between clients' perceptions of the alliance, PI techniques and CB techniques in the prediction of post-session changes. More PI and more CB techniques and more PI but fewer CB techniques were associated with better post-sessions changes in the context of higher alliances. More CB techniques but fewer PI techniques and fewer PI and fewer CB techniques were not significantly associated with post-session changes in the context of higher (or lower) alliances. Copyright © 2012 John Wiley & Sons, Ltd.
Key Practitioner Message
- Clients' perceptions of PI techniques in the context of stronger alliances were most beneficial for post-session outcomes. Thus, a high alliance will likely maximize the impact of PI techniques.
- Clients who rated their therapist as being relatively inactive reported fewer positive post-session outcomes, suggesting that an idle therapeutic approach is not advantageous.
- Therapist differences explained two to three times more variation in session outcomes than client ratings of alliance or techniques. Some therapists are better at facilitating positive session outcomes as compared with others, suggesting that a potential key barometer of therapists' effectiveness may be captured by session outcomes.