Patient pretreatment interpersonal problems and therapeutic alliance in short-term cognitive therapy.

Abstract

The growing consensus regarding the importance of interpersonal process in psychotherapy, as well as of interpersonal factors in self-definition, has underscored the relevance of examining patient interpersonal functioning as it relates to the development of the therapeutic alliance. This study examined the relationship of patient pretreatment interpersonal functioning (as measured by the Inventory of Interpersonal Problems and the Million Clinical Multiaxial Inventory) to the therapeutic alliance (as measured early in treatment by a patient self-report version of the Working Alliance Inventory). On the basis of an interpersonal circumplex interpretation, the results generally indicated that friendly-submissive interpersonal problems were positively related to the development of aspects of the alliance and that hostile-dominant problems were negatively related to the development of aspects of the alliance early in short-term cognitive therapy.

Interpersonal Subtypes in Social Phobia: Diagnostic and Treatment Implications

“…For example, interpersonal problems influence the development of the therapeutic alliance, with friendly-submissive patients being able to form an alliance much easier than cold-dominant patients (Muran et al, 1994). Similarly, several research studies have also shown that friendly-submissive interpersonal problems are positively related to psychotherapy outcome, whereas cold-dominant interpersonal problems are negatively related to outcome in both cognitive-behavioral and psychodynamic therapy (Borkovec et al, 2002;Horowitz et al, 1993).…”

“…Third, we examined subtype differences on posttreatment measures of general symptom severity, level of social anxiety, psychological well-being, level of optimism, and satisfaction with social functioning. Extensive research using the IIP-C has shown that friendly-submissive interpersonal problems are positively related to psychotherapy outcome, whereas hostile-dominant problems are negatively related to outcome (e.g., Gurtman, 1996;Horowitz et al, 1992;Horowitz, Rosenberg, & Bartholomew, 1993;Kasoff & Pincus, 2002;Muran et al, 1994). Therefore, we predicted that socially phobic patients with friendly, exploitable, and submissive interpersonal problems would respond more positively to psychotherapy than socially phobic patients with avoidant, cold, and hostile interpersonal problems.…”

“…Empirical studies have demonstrated that many forms of pathology are associated with interpersonal impairment including depression (Joiner, 2002), bipolar disorder (Miklowitz, 2001), substance abuse and dependence (Fals-Stewart, Birchler, & O'Farrell, 1999), and personality disorders Russell, Moskowitz, Zuroff, Sookman, & Paris, 2007). Empirical studies have also demonstrated that interpersonal characteristics are associated with therapeutic alliance (e.g., Muran, Segal, Samstag, & Crawford, 1994) and therapeutic outcome (e.g., Alden & Capreol, 1993;Blatt, Zuroff, Quinlan, & Pilkonis, 1996;Ruiz et al, 2004).…”

“…The alpha coefficients in this sample ranged from .76 for the Intrusive scale to .88 for the Nonassertive scale. The validity of the IIP-C has been supported in investigations of its relations with various forms of psychopathology (e.g., Kachin et al, 2001;Soldz, Budman, Demby, & Merry, 1993), therapeutic alliance (e.g., Muran et al, 1994), and psychotherapy outcome (e.g., Grosse Holtforth, Lutz, & Grawe, 2006;Maling et al, 1995;Ruiz et al, 2004).…”

Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity

“…[28][29][30] There is also evidence suggesting that personality dysfunction is associated with better treatment outcome in supportive and cognitive-behavioral interventions, 31-32 particularly when considered in the context of presenting distress. 33 Taken together, these data suggest that while many diagnosable Axis II conditions interfere with treatment efficacy, a certain degree of avoidant or submissive personality characteristics (of the kind associated with interpersonal sensitivity) may actually serve to augment benefit from interventions via a number of pathways (discussed in detail in the discussion section).…”