The impact of early empathy on alliance building, emotional processing, and outcome during experiential treatment of depression

Abstract

Empirical support was provided for the theorized relationships in experiential theory amongst the variables examined.

Fluctuations in alliance and use of techniques over time: A bidirectional relation between use of “common factors” techniques and the development of the working alliance

“…Additionally, therapists were more likely to use higher levels common factors techniques with patients with whom they established a stronger alliance early in treatment. This finding supports earlier studies which have shown a relation between supportive or rapport building techniques and better alliance (Ackerman & Hilsenroth, ; Karver et al, ; Malin & Pos, ). Our results perhaps suggest that techniques shared by all treatment modalities (rather than those that are theory driven) have a stronger impact on the development of alliance (Messer & Wampold, ).…”

“…To the best of our knowledge, only two small studies have found a positive relation between therapist use of common factors techniques earlier in treatment and a stronger patient‐reported alliance later in treatment among depressed adolescents (Karver et al, ) and adults (Malin & Pos, ).…”

“…We investigated the bidirectional techniques‐alliance relation in a sample of depressed patients who received supportive–expressive therapy (SET; Luborsky, ) as part of a larger randomized controlled trial (RCT; Barber et al, ). It is important to note that while our sample is relatively small ( N = 37), the majority of studies investigating the use of techniques had similarly sized samples (e.g., Ackerman et al, , N = 45; Crits‐Christoph et al, , N = 33; Connolly et al, , N = 29; Karver et al, , N = 23; Malin & Pos, , N = 30; Piper et al, , N = 64).…”

Early psychotherapeutic empathy, alliance, and client outcome: Preliminary evidence of indirect effects

“…Malin and Pos () investigated the links between empathic communication (as rated by observers of first session), alliance quality (as reported by clients after first session), and depressive symptom reduction (as reported by clients) in short‐term experiential therapy. Clients in this study were 30 depressed clients with relatively high or low alliance scores who were drawn from a larger client pool ( n = 74).…”

“…In contrast to Malin and Pos's () study, we utilized client ratings of empathy because we deemed the experience of empathy (Barrett‐Lennard, ) to be more relevant in this context than therapist‐rated attunement (Rogers, ) or observer‐rated communication (Rogers, ). In particular, we surmised that the effect of attunement/communication might be contingent on the client's perception of that attunement/communication; if a client is unaware of an empathic communication, then we would expect that she would be no more receptive (Wong, ) to therapeutic goals/tasks .…”