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Is the therapeutic alliance overvalued in the treatment of eating disorders?

Authors

  • Amy Brown DClinPsy,

    Corresponding author
    1. Department of Psychological Medicine, Institute of Psychiatry, King's College London, United Kingdom
    • Correspondence to: Amy Brown, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, UK. E-mail: amy.brown@kcl.ac.uk

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  • Victoria A. Mountford DClinPsy,

    1. Department of Psychological Medicine, Institute of Psychiatry, King's College London, United Kingdom
    2. Eating Disorder Service, South London and Maudsley NHS Foundation Trust, United Kingdom
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  • Glenn Waller DPhil

    1. Clinical Psychology Unit, Department of Psychology, University of Sheffield, United Kingdom
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ABSTRACT

In this article, we make the case for a systematic program of research into the causal relationship between the therapeutic alliance and outcomes of psychological treatments for the eating disorders. To make that case, we need to begin by considering the validity of existing assumptions about that alliance-outcome relationship. We will then suggest what research is needed to allow clinicians to structure their work to best effect (e.g., should therapists focus on establishing a strong alliance even if it means not applying more therapy-specific techniques, or should they stress the application of those techniques even when the working alliance might seem likely to be weakened as a result). Although the authors have a background in cognitive-behavioral therapy (CBT), our aim is to suggest a research base that applies to a variety of psychotherapies, allowing for common or different conclusions about the alliance-outcome relationship, depending on what the proposed research indicates. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:779–782)

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