The patient-therapist relationship: Research from the psychodynamic perspective

Waterhouse, G

doi:10.1016/0272-7358(84)90037-0

Cited by 37 publications

(15 citation statements)

References 36 publications

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“…The importance of therapeutic alliance extends to treatment outcome. The results of metaanalyses and individual studies provide strong support for the role of the therapeutic alliance in psychotherapy outcome (Bordin, 1979;Dierick and Lietaer, 1990;Gaston, 1990;Hatcher et al, 1995;Horvath and Luborsky, 1993;Lambert et al, 1986;Luborsky et al, 1990;Waterhouse and Strupp, 1984;Weinberger, 1995). The psychotherapy research literature indicates that therapeutic alliance appears to be an important predictor of outcome in individual psychotherapy, including long-and short-term therapies and treatments for many therapeutic orientations (Eaton et al, 1988;Gaston et al, 1991;Henry et al, 1994;Horvath and Symonds, 1991).…”

Section: Predictors Of Engagementmentioning

confidence: 98%

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et al. 2002

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Factors that may influence engagement into a family-ecological psychosocial intervention and a nondirective psychosocial intervention designed for HIV+ asymptomatic women were examined. Participants were 136 HIV+ African American women. Participant characteristics and therapeutic alliance were examined as possible predictors of engagement. Both participant characteristics and therapeutic alliance had some power in predicting engagement. However, fewer participant characteristics than expected were statistically significant. Statistically significant results indicate that women who had more daily hassles, more distress, more social support, and more disagreements with their spouse were more likely to engage in the intervention. The strongest predictor of engagement was therapeutic alliance, indicating the importance of the alliance between the HIV+ participant and the interventionist. The importance of these findings is discussed.

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Section: Predictors Of Engagementmentioning

confidence: 98%

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et al. 2002

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“…A great deal of empirical data strongly support the therapeutic efficacy of the working alliance (Dierick & Lietaer, 1990; Gaston, Mannar, Gallagher, & Thompson, 1991; Luborsky, Barber, & Crits‐Christoph, 1990; Orlin‐sky & Howard, 1986; Saltzman, Luetgert, Roth, Greaser, & Howard, 1976; Waterhouse & Strupp, 1984). This support is most clearly evidenced in a meta‐analysis conducted by Hovarth and Symonds (1991).…”

Section: The Relationshipmentioning

confidence: 99%

Common factors aren't so common: The common factors dilemma.

Weinberger¹

1995

Clinical Psychology: Science and Practice

174

175

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There is apparently little difference in the effectiveness of different kinds of psychotherapy. One explanation is that common factors cut across them. The major schools do not much attend to common factors, however, and it may be that outcome equivalence is due as much t o common neglect of common factors as t o their use. Five common factors are discussed: the therapeutic relationship, expectations, confronting problems, mastery, and attribution of outcome. Linear conceptions of causality seem to contribute t o the problem of selective neglect of common factors, and it is suggested that reciprocal interaction may constitute a more viable way of understanding therapeutic processes. Although technical eclecticism and therapy integration have been proposed as potentially integrating the common factors, eclecticism lacks theoretical coherence, and viable integrations have yet t o be offered, although statistical methods for testing them (causal modeling) may exist. To suggest what a productive integration could look like, a clinical example is connected metaphorically t o a developmental model of attachment.Strategies for further research are also suggested.

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“…Similarity of demographic char acteristics between clients and therapists have been found to have a positive effect on therapeutic expectations and outcome [30][31][32], although other studies suggest this may not be the case [33][34][35], Similarity of cognitive character istics between therapists and clients has been associated with favourable outcome [36][37][38], while still other re search has failed to confirm this [39][40][41], More recently, similar locus of control orientations between therapist and client has been associated with more favourable client expectations [42], Knowledge of the role of the patient-therapist relation ship in dropout also remains elusive. This may seem odd given that psychotherapeutic process and outcome can be viewed as largely mediated by the patient-therapist rela tionship [43], Mutuality of goals and agreement regarding tasks and responsibilities are important elements of this relationship [44], Yet patients and therapists may dis agree about the most effective ways of realising such goals [45,46] and researchers may need to become more aware of the ways in which events occurring in therapy are per ceived differently by therapists and patients. There is evi dence that both patients' and therapists' views of their mutual relationship early in therapy are related to prema ture termination [47], Moreover, the psychotherapeutic process has been found to be facilitated when there is con sensus between patient and therapist, and they have simi lar role expectations [48][49][50][51][52], A major problem with research into patient dropout has been the definition of terms.…”

Section: Introductionmentioning

confidence: 99%

Why Do Eating Disorder Patients Drop Out?

Clinton¹

1996

Psychother Psychosom

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Background: Dropout from psychotherapy is an important problem that has received little systematic attention. Although previous research suggests that the number of patients who drop out is considerable, it is not clear why they drop out or what might be done to limit the problem. The present study attempted to examine the role of the patient-therapist relationship as well as other variables for dropout among eating disorder patients. Methods: Eating disorder patients and their therapists were assessed on a measure of treatment expectations previously developed by the author: the former were also assessed on measures of psychiatric symptoms (Crown-Crisp Experiential Index) and eating disorder psychopathology (Eating Disorder Inventory), as well as relevant background and treatment variables. Patients were divided into those who had completed their course of treatment, and those who dropped out during assessment or treatment. Results: Lack of congruence between patients’ and therapists’ expectations of potential treatment interventions was associated with increased risk of dropout, whereas other patient-, therapist-and treatment-specific factors were not. In particular, dropouts had significantly greater expectations of being helped by insight-related interventions than their therapists. Conclusions: Dropout among eating disorder patients appears to be related to the patient-therapist relationship. It may be important for therapists to openly discuss patient expectations of treatment from the outset, and focus on particular areas of discrepancy to limit potential dropout.

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The patient-therapist relationship: Research from the psychodynamic perspective

Cited by 37 publications

References 36 publications

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Common factors aren't so common: The common factors dilemma.

Why Do Eating Disorder Patients Drop Out?

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