Treatment preferences affect the therapeutic alliance: implications for randomized controlled trials.

Abstract:

:The influence of treatment preferences on the development of the therapeutic alliance was investigated. Seventy-five patients were followed while participating in a randomized controlled trial comparing supportive-expressive psychotherapy with sertraline or pill placebo in the treatment of major depressive disorder. Therapeutic alliance was assessed before treatment and at the 3rd, 5th, and 9th weeks of treatment. Among patients initially preferring psychotherapy, those receiving psychotherapy experienced increases in their alliance over time, whereas those receiving active medication or placebo experienced decreases. Among patients preferring pharmacotherapy, there were no differences in alliance development whether they received psychotherapy, active medication, or placebo. These relations were observed even when controlling for symptom severity. Thus, the congruence of patients' treatment preference and the treatment that they ultimately received influenced the development of the therapeutic alliance. Because alliance is a robust predictor of outcome, treatment preferences may need to be carefully considered in randomized controlled trial settings.

journal_name

J Consult Clin Psychol

authors

Iacoviello BM,McCarthy KS,Barrett MS,Rynn M,Gallop R,Barber JP

doi

10.1037/0022-006X.75.1.194

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

194-8

issue

1

eissn

0022-006X

issn

1939-2117

pii

2007-00916-022

journal_volume

75

pub_type

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