The therapeutic alliance has demonstrated an association with favorable psychotherapeutic outcomes in the treatment of eating disorders (EDs). However, questions remain about the interrelationships between early alliance, early symptom improvement, and treatment outcome. We conducted a meta-analysis on the relations among these constructs, and possible moderators of these relations, in psychosocial treatments for EDs. Twenty studies met inclusion criteria and supplied sufficient supplementary data. Results revealed small-to-moderate effect sizes, bs 5 0.13 to 0.22 (p < .05), indicating that early symptom improvement was related to subsequent alliance quality and that alliance ratings also were related to subsequent symptom reduction. The relationship between early alliance and treatment outcome was partially accounted for by early symptom improvement. With regard to moderators, early alliance showed weaker associations with outcome in therapies with a strong behavioral component relative to nonbehavioral therapies.However, alliance showed stronger relations to outcome for younger (vs. older) patients, over and above the variance shared with early symptom improvement. In sum, early symptom reduction enhances therapeutic alliance and treatment outcome in EDs, but early alliance may require specific attention for younger patients and for those receiving nonbehaviorally oriented treatments.Resumen: Objetivo: La alianza terap eutica entre paciente y terapeuta ha demostrado ser una relaci on con resultados psicoterap euticos favorables en el tratamiento de los trastornos de la conducta alimentaria (TCA). Sin embargo, quedan preguntas acerca de la inter-relaci on entre alianza temprana, mejoría temprana de síntomas y resultados del tratamiento. Hicimos un meta-an alisis de la relaci on entre estos constructos y los posibles moderadores de estas relaciones en los tratamientos psicosociales para TCA. M etodo: Veinti un estudios reunieron los criterios de inclusi on y aportaron suficientes datos suplementarios. Resultados: los resultados revelaron un efecto de la talla pequeño a moderado, b 5 0.13 a 0.22 (p < .05), encontrando que la mejoría temprana de los síntomas estuvo relacionada con la subsecuente calidad de la alianza y las calificaciones de la alianza tambi en estuvieron relacionadas con la subsecuente reducci on de los síntomas. La relaci on entre alianza temprana y resultados de tratamiento fue parcialmente explicada por la temprana mejoría de los síntomas. Con relaci on a los moderadores, la alianza temprana mostr o d ebiles asociaciones con el resultado en terapias con un fuerte componente conductual relativo a terapias no conductuales. Sin embargo, la alianza mostr o m as fuerte relaci on con los resultados para pacientes m as j ovenes (versus mayores), por encima y sobre la varianza compartida con la temprana mejoría de síntomas. Discusi on: En resumen, la reducci on temprana de los síntomas refuerza la alianza terap eutica y los resultados del tratamiento en TCA, pero la alianza temprana puede reque...
The study aimed at constructing a reliable and valid post-session questionnaire measuring general change mechanisms of psychotherapy with correspondent versions for patient and therapist perspectives. Therefore, 253 inpatients in early, middle, and late stages of psychotherapy completed the newly developed Scale for the Multiperspective Assessment of General Change Mechanisms in Psychotherapy (SACiP) and diverse outcome measures. The psychometric qualities of the SACiP were excellent as shown by (a) exploratory factor analyses on patient and therapist ratings, (b) confirmatory factor analyses on later measuring times, and (c) high internal consistencies. Supporting construct validity, the SACiP predicted outcome, as shown by correlational analyses and mixed effects modeling. Patient evaluations of change mechanisms were better predictors of outcome than the corresponding therapist evaluations.
Mind-body practices enjoy immense public and scientific interest. Yoga and meditation are highly popular. Purportedly, they foster well-being by curtailing self-enhancement bias. However, this "ego-quieting" effect contradicts an apparent psychological universal, the self-centrality principle. According to this principle, practicing any skill renders that skill self-central, and self-centrality breeds self-enhancement bias. We examined those opposing predictions in the first tests of mind-body practices' self-enhancement effects. In Experiment 1, we followed 93 yoga students over 15 weeks, assessing self-centrality and self-enhancement bias after yoga practice (yoga condition, n = 246) and without practice (control condition, n = 231). In Experiment 2, we followed 162 meditators over 4 weeks (meditation condition: n = 246; control condition: n = 245). Self-enhancement bias was higher in the yoga (Experiment 1) and meditation (Experiment 2) conditions, and those effects were mediated by greater self-centrality. Additionally, greater self-enhancement bias mediated mind-body practices' well-being benefits. Evidently, neither yoga nor meditation fully quiet the ego; to the contrary, they boost self-enhancement.
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