Dissertations / Theses: 'Therapeutic alliance, psychotherapy process'

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Goldman, Elizabeth Davis. "Chicken or egg, Alliance or Outcome: An attempt to answer an age old question." Ohio University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1220483624.

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Reynolds, D'Arcy James. "Session Impact and Alliance in Internet Based Psychotherapy." Miami University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=miami1248277605.

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3

Uhlin, Brian. "Therapist In-session Rated Facilitative Interpersonal Skills (FIS-IS) in the Psychotherapy Process." Ohio University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1312482707.

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4

Wing, Edgar H. Jr. "The Relationship between Therapist Empathy, the Working Alliance, and Therapy Outcome: A Test of a Partial Mediation Model." Ohio University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1262266810.

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Schielke, Hugo Josef. "Systemic Alliance and Progress in Individual Therapy: The Influence of Indirect Client System Alliance on Process and Progress in Individual Therapy." Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1385655060.

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LOCATI, FRANCESCA. "Cyclical dynamics in the therapy room: The interactive role of the therapeutic alliance in psychotherapy process." Doctoral thesis, Università degli Studi di Milano-Bicocca, 2016. http://hdl.handle.net/10281/102821.

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The last decades have seen an exponential trend toward a relational reconsideration of psychoanalysis (Greenberg & Mitchell, 1983), that has drastically influenced aspects of both psychotherapy theory and research. On the theoretical side, indeed, the therapeutic process has been reformulated under an intersubjective perspective, and it is now conceived as a “specific psychological field” created by the interplay between the patient’s and therapist’s subjectivities (Stolorow, Brandchaft & Atwood, 2014). On the research side, the construct of therapeutic alliance as a relational dimension has become very important. Accordingly, recent conceptualizations define the therapeutic alliance as an “intersubjective negotiation process” (Safran & Muran, 2000) that interacts with the other variables of the therapeutic process (Roth & Fonagy, 2013), although little is still known about the precise dynamic involving these key dimensions. On these grounds, the present doctoral thesis aims to explore the role of the therapeutic alliance in the therapeutic process, by means of an intersubjective perspective in both group and single-case studies. The first part of the thesis investigates the interaction between therapeutic alliance, technical interventions and metacognitive functioning in groups of patients, by focusing in a first study on the earliest stage of the treatment and, in a second one, on the more advanced stages. Results of both studies show that technical interventions and therapeutic alliance are associated in specific interactive patterns that can be differentiated in three different levels of therapeutic alliance: a positive, a neutral and a negative level. Furthermore, in these interactive patterns, metacognitive functioning plays a specific role of mediator depending on the level of alliance. The second part of the thesis includes two single-case studies, involving a patient with an anxiety disorder diagnosis and with a deferential behavior toward the therapist. The first study specifically focuses on the patient’s collaborative alliance and its association with defense mechanisms, therapeutic relationship and therapist’s technical interventions. On the contrary, the second study focuses on the investigation of alliance ruptures and their interaction with transference patterns and defense mechanism. Results show that the intersubjective approach applied on the deferential behavior, on the one hand challenges the real authenticity of patient’s collaborative process, and on the other hand suggests that ruptures may provide a better understanding of the patient’s transference and defense mechanisms. Overall, this doctoral thesis indicates that the therapeutic process can be conceived as an interpersonal cyclical dynamic that involves both technical and relational factors. In this sense, the therapeutic alliance may be considered as a medium, by means of which other variables operate during the therapy.

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Goldman, Gregory A. "Quality of Object Relations, Security of Attachment, and Interpersonal Style as Predictors of the Early Therapeutic Alliance." Ohio University / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1132069514.

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8

Stone, Suzannah J. "The Role of Therapist Facilitative Interpersonal Skills in Predicting Alliance and Outcome in Psychotherapy." Ohio University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1625222441713288.

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9

Lilliengren, Peter. "Exploring therapeutic action in psychoanalytic psychotherapy : Attachment to therapist and change." Doctoral thesis, Stockholms universitet, Psykologiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-106501.

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The overall aim of this thesis was to explore therapeutic action in psychoanalytic psychotherapy from different perspectives (patient, therapist, observer), using different methodological approaches (qualitative and quantitative). Study I explores patients’ views of therapeutic action with grounded theory methodology. The results indicated that talking openly in a safe therapeutic relationship led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up” and experiencing something missing in treatment. Study II investigates experienced therapists’ views of therapeutic action. The development of a close and trusting relationship was perceived as the core curative factor. Patients’ fear of closeness hindered treatment from the therapists’ perspective. Study III involves the development and psychometric examination of a new rating scale for patient-therapist attachment (Patient Attachment to Therapist Rating Scale; PAT-RS). Inter-rater reliability was good for three of the subscales (Security, Deactivation, Disorganization), but poor for one (Hyperactivation). Patterns of correlations with other measures suggest construct validity for the reliable subscales. Study IV examines the relationships between secure attachment to therapist, alliance, and outcome. Linear mixed-effects models, controlling for therapist effects, treatment length and patient-rated alliance, indicated that secure attachment to therapist relates to outcome. Further, the unique variance associated with secure attachment to therapist predicted continued gains in functioning during follow-up. The results of this thesis suggest that the development of a secure attachment to the therapist is a central mechanism of therapeutic change. The results are discussed in relation to established notions of therapeutic action in psychoanalytic psychotherapy. Two tentative process models that may be useful for clinical practice and future research are proposed.

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Epub ahead of print.

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Davis, Elizabeth Helen. "Detection of Rupture-Repair Sequences in Patterns of Alliance Development: The Effects of Client vs. Therapist Raters and Therapist Training Status." Ohio University / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1133405084.

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11

Ryan, Elizabeth. "The Therapeutic Alliance in Cognitive Therapy for Depression in Combination with Antidepressant Medication: Relations to Subsequent Symptom Change and Treatment Retention." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1262278719.

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Odhammar, Fredrik. "Möten i psykodynamisk barnpsykoterapi : Förväntningar, samspel och förändring." Doctoral thesis, Stockholms universitet, Institutionen för pedagogik och didaktik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-145474.

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This thesis aims to increase the knowledge of courses and processes of change prior to and during psychodynamic child psychotherapy with parallel parent contact. The dissertation examines parents’ and psychotherapists’ stated goals and expectations prior to the child’s psychotherapy, processes of change focusing on the psychotherapeutic encounter between child and psychotherapist, and outcome gauged by standardized measures compared to experienced change regarding the child’s problems. This dissertation also wants to examine different instruments for describing the psychotherapeutic process. Data was collected from systematic case studies, at different times during the course of psychotherapy, with material from different sources, such as child psychiatric assessment before and after conducted psychotherapy, questionnaires, and video taping of therapy sessions. By examining the therapeutic encounter from the perspectives of child, parent and psychotherapist, an image of psychotherapy, which illustrates the complexity of the psychotherapeutic process, was created. The thesis is based on three articles: Study I examines parents’ and psychotherapists’ goals and expectations prior to psychotherapy. Study II is a close study of a video-taped individual therapy, in which the interaction between child and therapist is examined with the rating instrument Child Psychotherapy Q-set (CPQ), the psychotherapist’s description of the psychotherapy’s process, and the self-rating instrument Feeling Word Checklist (FWC-24). Study III examines change in global functioning ability after child psychotherapy. By examining several psychotherapies in order to construct qualitative understanding of low and high change, respectively, in rated global functioning, limitations in the rating instrument Children’s Global Assessment Scale (CGAS) are analyzed. The results point to: 1. The need for a culture of cooperation between family and the one conducting the treatment, where goals are formulated together and in accordance with the family’s frame of reference and life experiences, which can increase the possibility of creating positive expectations, and of adapting treatment to the family in question. 2. Different methods of examining psychotherapy reflect and complete the image of the psychotherapy process. 3. The psychotherapy process’s complexity and the difficulty in describing the effect of therapy with simple measurements or remaining psychiatric symptoms. Positive change in several areas, such as the child experiencing increased independence, gets access to more positive affections, has improved self-esteem and a more optimistic idea of the future, could be described as psychological phenomena and can be difficult to encompass with narrow psychiatric terminology. 4. The intersubjectivity between child and psychotherapist appears essential. The therapist’s attitude and interventions are characterized by creating a steady therapeutic framework for exploring the child’s problems. 5. The importance of the therapist’s meta-competence, i.e., overarching competencies that psychotherapists need to use to guide any intervention, what interventions to use, and when they are suitable.

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 2: Submitted.

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Geremia, Lisiane. "A aliança terapêutica: um estudo de processo de uma paciente diagnosticada com transtorno de personalidade borderline." Universidade do Vale do Rio dos Sinos, 2015. http://www.repositorio.jesuita.org.br/handle/UNISINOS/5024.

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As pesquisas em psicoterapia têm contribuido para o estudo da Aliança Terapêutica, seu desenvolvimento e manutenção no processo de tratamento com pacientes diagnosticados com diversos transtornos. Através da exploração minuciosa de ações do processo, incluindo variáveis do paciente, do terapeuta e da interação, se torna possível compreender o que ocorre dentro de um setting terapêutico e como a Aliança Terapêutica se desenvolve em uma psicoterapia. Poucos estudos direcionam suas investigações para os pacientes diagnosticados com o Transtorno de Personalidade Borderline, principalmente, na descrição dos processos e dos resultados terapêuticos. Essa dissertação de mestrado teve como principal objetivo avaliar a Aliança Terapêutica no processo de psicoterapia de uma jovem diagnosticada com o Transtorno de Personalidade Borderline. Para tal, 12 sessões de psicoterapia psicanalítica foram codificadas através de dois instrumentos, um que avalia a Aliança Terapêutica e, o segundo focalizando o estudo do processo terapêutico. O Working Alliance Inventory Observer Form (WAI-O) busca avaliar a Aliança Terapêutica por meio de 36 itens que investigam as três subescalas presentes no tratamento, os Objetivos, as Tarefas, e o Vínculo. O Psychotherapy Process Q-set (PQS) visa avaliar sessões de psicoterapia através de 100 itens que descrevem o terapeuta, as atitudes e os comportamentos do paciente, bem como as interações terapeuta/paciente. O primeiro estudo consiste na análise e descrição da Aliança Terapêutica na psicoterapia durante o período de seis meses de tratamento, visando compreender as qualidades dessa relação ao longo desse recorte de sessões e posteriormente nas três etapas divididas do tratamento. O segundo, investiga em profundidade a Aliança Terapêutica no processo de uma psicoterapia através da integração das anotações clínicas, narrativas realizadas através dos cinco itens mais e cinco itens menos característicos do processo e da correlação das categorias do Psychotherapy Process Q-Set (PQS) com as subescalas do Working Alliance Inventory Observer Form (WAI-O). Portanto, esta dissertação aponta que a Aliança Terapêutica é um fator de muita importância no processo de uma psicoterapia, especialmente no tratamento de pacientes graves e, que o vínculo e a postura empática e sensível da terapeuta são ingredientes essenciais nesse processo.
Psychotherapy research have contributed for the study of therapeutic alliance, its development and maintenance during the treatment of patients diagnosed with many disorders. By thorough exploration of the actions of the process, including patient, interaction and therapist variables, it is possible understand what happens in a therapeutic setting and how the Therapeutic Alliance develops in psychotherapy. Few studies directed their research to patients diagnosed with Borderline Personality Disorder, especially in the description of processes and therapeutic results. This Master's dissertation aimed to evaluate the Therapeutic Alliance in the psychotherapy process of a young woman diagnosed with Borderline Personality Disorder. For such, 12 psychoanalytic psychotherapy sessions were coded by two instruments, one that evaluates the Therapeutic Alliance and the second focusing on the study of the therapeutic process. The Working Alliance Inventory Observer Form (WAI-O) seeks to assess the Therapeutic Alliance through 36 items, investigating the three subscales present in the treatment: the Objectives, the Tasks, and the Bond. The Psychotherapy Process (PQS) aims to assess the psychotherapy sessions through 100 items describing the therapist, the attitudes, the behavior of the patient and the therapist/patient interactions. The first study is the analysis and description of the Therapeutic Alliance in psychotherapy, during the six months of treatment, to understand the qualities of this relationship during these sessions, and later in the three stages of treatment. The second one investigates in depth the process of the Therapeutic Alliance of psychotherapy through the integration of clinical notes, narratives made through the five most typical items and five less typical items of the process, and the correlation of the categories of the Psychotherapy Process Q-Set (PQS) with the subscales of the Working Alliance Inventory Observer Form (WAI-O). Therefore, this dissertation points out that the Therapeutic Alliance is a factor of great importance in the process of psychotherapy, especially in the treatment of critically ill patients and the bond, as well as the empathic and sensitive attitude of the therapist are essential components in this process.

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Gray, Mikael Alicia Ketring Scott A. "Therapeutic alliance as a mediating factor between couple expectancy and therapeutic outcome." Auburn, Ala., 2006. http://repo.lib.auburn.edu/2006%20Summer/Theses/GRAY_MIKAEL_58.pdf.

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15

Goldsmith, Jacob Ze'ev Barnett. "Split Alliance in Couple Therapy: Exploration of Four Types of Alliance Discrepancy." Oxford, Ohio : Miami University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1208873527.

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Whelchel, Holly L. Ketring Scott A. "Therapeutic alliance as a mediating factor between couple attachment and therapeutic outcome." Auburn, Ala., 2005. http://hdl.handle.net/10415/1282.

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17

MacFarlane, Peter. "The Therapeutic Alliance from the Clients' Perspective: a Qualitative Approach." Ohio : Ohio University, 2009. http://www.ohiolink.edu/etd/view.cgi?ohiou1227106093.

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Davis, Jeffrey J. "The working alliance and internalization of the relationship in psychotherapy /." free to MU campus, to others for purchase, 1996. http://wwwlib.umi.com/cr/mo/fullcit?p9737908.

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Nishida, Jacob B. "Client attachment, symptom distress, marital adjustment, and therapeutic alliance in couple's therapy." Auburn, Ala., 2007. http://repo.lib.auburn.edu/07M%20Theses/NISHIDA_JACOB_7.pdf.

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20

Del, Giacco Luca. "The Mutual Regulation Processes During the Psychodynamic Psychotherapy of Depression: An Observational Study of Communicative Acts in the Construction of the Early Therapeutic Alliance = Los Procesos de Regulación Mutua Durante la Psicoterapia Psicodinámica de la Depresión: Un Estudio Observacional de los Actos Comunicativos en la Construcción de la Alianza Terapéutica Temprana." Doctoral thesis, Universitat de Barcelona, 2021. http://hdl.handle.net/10803/672568.

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Therapeutic conversation represents a continuous and dynamic activity of meaning construction turn by turn, based on a two-way interpretative process between therapist and patient. In particular, verbal structures and intents, vocal characteristics, and speech interruptions are indivisible and fundamental elements of therapeutic discourse; they convey psychological and emotional processes that transform the internal organization of individuals into more complex structures, fostering change. During this activity, verbal and non-verbal components interact with each other, forming a non-linear communication field that expresses the therapeutic process and the clinical function of the therapeutic relationship and fosters the development and regulation of factors such as the therapeutic alliance. This relational dimension, influenced by communicative coordination processes underlying the mutual regulation between participants, is predictive of change, especially in the early stages of psychotherapy. During the therapeutic interaction, patients experience alliance construction by manifesting different verbal and non-verbal behaviors whereby they express their psychological processes and symptoms. In particular, depressed patients present verbal, vocal, and interruption behaviors that are an expression of their symptomatology and impact on communicative exchanges with the therapist, hindering the development and maintenance of the therapeutic alliance and change. In literature, the predominance of verbal communication over the above-stated components resulted in a fragmented communicative field with distinct theories and measurement tools, which prevented the understanding of therapist-patient dynamics and their role in the construction of the early therapeutic alliance at the process level. Studies analyzing the dynamics between communication (as a single and interacting communicative field) and relational aspects in the therapist-patient interplay are absent, especially in the Italian context and in brief focal psychotherapy with depressed patients. Therefore, this doctoral thesis as a collection of two publications aims to identify the verbal, vocal, and interruption behaviors emerging turn by turn between the therapist and depressed patient within psychodynamic psychotherapy and investigate those communicative modes of each participant that foster the alliance construction by the other during mutual regulation processes. A particular case of indirect observational methodology was implemented; as a mixed method in itself, it was able to provide a fuller picture of the therapeutic interaction by supporting it with objective measures. Thirty audio recordings and transcripts of brief focal psychotherapy sessions with ten depressed patients treated by the same therapist (8,327 speaking turns) were considered. The observational design selected to guide and organize the investigation was nomothetic/follow-up/multidimensional, given its greater wealth of information and complexity among low-intensity evaluation designs. Study 1, focused on identifying communicative behaviors through a theory that unify the communicative field, resulted in the construction of an ad hoc indirect observation instrument of the therapeutic conversation based on the performative function of the Speech Act Theory. This classification system showed high intra-and inter-observer reliability and made it possible to describe the participants’ communicative modes trend. Study 2 aimed to investigate the communicative modes of the therapist and depressed patients that, according to the literature, foster the mutual construction of the early therapeutic alliance: asking, exploring, elaborating, and interrupting cooperatively for the former; affirming, exploring, expressing emotions, and interrupting cooperatively for the latter. The study showed the presence of sequential patterns and significant relationships between the selected communicative behaviors and this relational dimension during the mutual regulation processes. All this allows increasing knowledge about these dynamics, providing professionals with useful information to improve the treatment effectiveness and to advance in the application of the mixed-methods approach in the field of psychotherapy research.
Durante la psicoterapia psicodinámica, los componentes verbales (estructuras e intenciones) y no verbales (voz e interrupciones) interactúan entre sí, transmitiendo procesos psicológicos y emocionales y formando un campo comunicativo no lineal en la base de la alianza terapéutica. Esta dimensión relacional predice el cambio, influenciada por los intercambios paciente-terapeuta desde las etapas iniciales del encuentro. Los pacientes deprimidos presentan comunicación verbal y no verbal específica y muestran dificultades para desarrollar y mantener la alianza terapéutica. Esta tesis doctoral tiene como objetivo identificar las conductas verbales, vocales y de interrupción que emergen turno tras turno entre el terapeuta y el paciente deprimido dentro de la psicoterapia psicodinámica e investigar aquellos modos comunicativos de cada participante que fomentan la construcción de la alianza durante la regulación mutua. Se aplicó un caso particular de metodología observacional indirecta como método mixto en sí mismo y se consideraron 30 grabaciones de audio y transcripciones de sesiones de psicoterapia con diez pacientes deprimidos tratados por la misma terapeuta (8,327 turnos de habla). El diseño observacional fue nomotético, de seguimiento y multidimensional. El estudio 1, centrado en la identificación de las conductas comunicativas a través de una teoría unificadora del campo comunicativo, produjo un instrumento de observación indirecta ad hoc de la conversación terapéutica basado en la función performativa de la Teoría de los Actos del Habla. Este sistema de clasificación mostró una alta fiabilidad intra e inter-observador y permitió describir la tendencia de los modos comunicativos de los participantes. El estudio 2 investigó los modos comunicativos del terapeuta y de los pacientes deprimidos que, según la literatura, fomentan la construcción mutua de la alianza terapéutica temprana: preguntar, explorar, elaborar e interrumpir cooperativamente para el primero; afirmar, explorar, expresar emociones e interrumpir cooperativamente para el segundo. Se detectaron patrones secuenciales y relaciones significativas entre las conductas comunicativas seleccionadas y la dimensión relacional durante los procesos de regulación mutua. Todo ello permite aumentar el conocimiento de estas dinámicas, proporcionando a los profesionales información útil para mejorar la eficacia del tratamiento y avanzar en la aplicación del enfoque de mixed methods en el campo de la investigación en psicoterapia.

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Walker, Catherine E. Ketring Scott A. "The effect of demographic variables on therapy alliance in couple therapy controlling for relationship adjustment and symptom distress." Auburn, Ala, 2008. http://hdl.handle.net/10415/1563.

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McLean, Cassie M. "Therapeutic Alliance in Pediatric Occupational Therapy." Wittenberg University Honors Theses / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=wuhonors1617637354771075.

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Patterson, Candace L. "Pretreatment Role Expectations, Alliance, and Outcome." Ohio University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1276547700.

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Delaney, Robin Ostrom. "Therapeutic alliance in couples therapy the influence of gender, who initiated therapy, split alliance, and the presenting problem /." Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1155693036.

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Levi, Judith. "Therapeutic factors : a process study of small group psychotherapy." Thesis, University of Hull, 2006. http://hydra.hull.ac.uk/resources/hull:11516.

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There is a need for structured research into the psychodynamic psychotherapies to strengthen evidence-based practice knowledge and communicate this knowledge to practitioners and funders. We know that group psychotherapy is effective, but many outcome assessment instruments fail to reflect process and individual experience. The current study used the Therapeutic Factors Questionnaire in an attempt to add to research knowledge of process. In this exploratory study, twenty-two participants in small group psychotherapy at a day attendance therapeutic community rated eleven factors for perceived helpfulness in a modified version of Yalom's Therapeutic Factors Questionnaire, at five time points in the year. Therapists completed an identical version for each member, conveying what they thought each member had found most helpful in that period. Members who had been in the group for a year participated in a semi-structured interview, which was analysed using Interpretative Phenomenological Analysis. TFQ data was collated into three six-month phases dependent on length of time in the group. Admission data on individual clinical problems was coded by the researcher into nine categories. Lower than expected numbers made the drawing of conclusions from the quantitative data impossible, though statistical analysis showed certain trends. However, interviews provided a particularly rich source of information, which also suggested that the TFQ trends were probably authentic. Two complete cases were explored in terms of the relationship between TFQ and interview results.

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Porter, Robert D. "Client symptom distress, stage of change, and the therapeutic alliance in couple therapy." Auburn, Ala., 2007. http://repo.lib.auburn.edu/07M%20Theses/PORTER_ROBERT_13.pdf.

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Meyer, Kevin J. "The relationship between therapists' use of humor and therapeutic alliance." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1186189837.

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Reynolds, D'Arcy James. "ONLINE DATA COLLECTION FOR PSYCHOTHERAPY PROCESS RESEARCH: SESSION IMPACT AND ALLIANCE EVALUATIONS." Oxford, Ohio : Miami University, 2004. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1091453348.

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Goldman, Gregory A. "Complementarity as a Moderator of the Rigidity-Alliance Relationship: Five Re-Analyses of Archival Data." Ohio : Ohio University, 2009. http://www.ohiolink.edu/etd/view.cgi?ohiou1246111883.

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Levin, Laura. "Adolescent Interpersonal Predictors of Early Therapeutic Alliance in Cognitive-Behavioral Therapy." Scholarly Repository, 2011. http://scholarlyrepository.miami.edu/oa_dissertations/701.

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This study examined interpersonal predictors of early therapeutic alliance in a cognitive-behavioral treatment study for adolescents with anxiety and/or depressive disorders. Client, therapist, and observer rated measures of alliance were obtained from the third session of treatment in a sample of twenty-seven adolescents. Results indicate that alliance ratings across the three perspectives are significantly associated with one another, but that pretreatment interpersonal variables were differentially associated with varying informant perspectives. Adolescents’ perceptions of their relationships to their caregivers positively related to their perceptions of the therapeutic alliance, such that adolescents with more positive representations of relationships with their attachment figures were more likely to endorse stronger working alliances early in treatment. Adolescent-reported symptom severity at pretreatment predicted observer ratings of alliance, such that adolescents who indicated greater symptoms at pretreatment were rated as having stronger early alliances with their therapists by independent observers. Adolescent perceptions of social support also predicted observer ratings of alliance. Therapists perceived having weaker alliances with adolescents showing clinically significant depression, as compared to adolescents diagnosed with anxiety disorders alone. Future research is needed to examine whether identification of relevant interpersonal factors can help improve therapeutic engagement and outcomes for the psychosocial treatment of adolescents with anxiety and depressive disorders.

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Stephens, Melissa Ketring Scott A. "Marital adjustment as a mediating factor between symptom distress and therapeutic alliance in couples therapy." Auburn, Ala., 2006. http://repo.lib.auburn.edu/2006%20Summer/Theses/STEPHENS_MELISSA_44.pdf.

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Boutin, Mélanie. "Relation entre l'alliance thérapeutique, la santé mentale ainsi que la satisfaction envers la thérapie au cours d'un processus psychothérapeutique chez l'adulte /." Chicoutimi : Trois-Rivières : Université du Québec à Chicoutimi ; Université du Québec à Trois-Rivières, 2005. http://dx.doi.org/doi:10.1522/24604477.

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Thèse (M.Ps.) -- Université du Québec à Chicoutimi, 2005.
"Mémoire présenté à l'Université du Québec à Chicoutimi comme exigence partielle de la maîtrise en psychologie offerte à l'Université du Québec à Chicoutimi en vertu d'un protocole d'entente avec l'Université du Québec à Trois-Rivières." Comprend des réf. bibliogr. : f. [123]-136. Document électronique également accessible en format PDF.

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Gillitt, Tarryn. "The mindful therapist: an interpretive phenomenological analysis of mindfulness meditation and the therapeutic alliance." Thesis, Rhodes University, 2011. http://hdl.handle.net/10962/d1002491.

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The aim of this study was to present and understand therapists’ experiences of the impact of their mindfulness meditation practice on their role in the therapeutic alliance. The topic emerged in response to extant research recommendations and researcher observations of the compatibility between mindfulness meditation outcomes and the demands on therapists for establishing effective alliances with clients. The study adopted an interpretive phenomenological analysis strategy located within the qualitative paradigm, and thus a small sample of therapists practicing mindfulness meditation were selected and interviewed on their experiences using semi-structured interviewing. Data were analysed for meaning units, which were then interpreted inductively and hermeneutically and categorized into superordinate themes. Three superordinate themes within participants’ experiences of how their mindfulness meditation practice impacts upon their role in the alliance were determined, namely: ‘self-care’; ‘insight into the structure of selfhood’; and ‘immediate mindfulness meditation during therapy’. This study found these experiences capacitated participants with compassionate interpersonal affects used for creating secure bonds with clients; skills for accurate empathic understanding; and skills and attitudes for working collaboratively with clients. Should future research confirm these findings, mindfulness meditation may be used as a tool to developed alliance formation abilities for therapists in training. Importantly, findings from this project called for a more comprehensive integration of theoretical positions on the construct of mindfulness meditation.

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Wing, Edgar H. "The relationship between therapist empathy, the working alliance, and therapy outcome a test of a partial mediation model /." Ohio : Ohio University, 2010. http://www.ohiolink.edu/etd/view.cgi?ohiou1262266810.

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Bieber, Luke J. "Anaclitic-Introjective Personality Traits and Client Outcomes in Psychoanalysis." Xavier University Psychology / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=xupsy1597811975774862.

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Perlman, Matthew R. "The Impact of Collaborative Alliance Feedback and Autonomous Motivation in Psychotherapy for Depression Symptoms." Ohio University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1483718918094171.

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Brucker, Penny Sue. "Examining the association between collaboration, therapeutic alliance, and psychotherapy outcome in a primary care medical setting /." The Ohio State University, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=osu1486394475981279.

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Crafford, Melody. "Attachment and the therapeutic relationship an elucidation of therapeutic process in a single child psychotherapy case." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1002464.

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The overall objective of this study was to delve into the intricacies of the therapeutic process and the therapeutic relationship from an attachment perspective. A single retrospective child case study was conducted, which entailed the construction of a narrative synopsis of the process. The hermeneutic approach of a Reading Guide Method was applied, and through a repeated re-reading of the narrative, pertinent themes emerged that shed light on therapy as a process in motion. Specifically, the motion of the therapeutic process manifested through a scrutiny of the therapeutic relationship in view of the participant’s attachment style. The results of this study revealed the capacity of the participant to move away from an avoidant and somewhat ambivalent organisation of defences by virtue of establishing a secure base and exercising her faculty for emotional and self-expression. Accordingly, it can be established that in view of psychotherapy from an attachment perspective, the seemingly imperceptible vicissitudes of change are indeed appreciable.

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Hornbeck, Cassie L. "The development of the therapeutic alliance with child clients the key components of a successful relationship /." Theological Research Exchange Network (TREN) Access this title online, 2005. http://www.tren.com.

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Green, Angela L. "To be (non)specific : the role of therapeutic alliance in group CBT for depression and anxiety /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17455.pdf.

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Niemeyer, Kristin M. "An Exploration of Object Relations and the Early Working Alliance in a University Clinic Sample." Thesis, University of North Texas, 2004. https://digital.library.unt.edu/ark:/67531/metadc4583/.

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The current study investigated the relationship between clients' object relations functioning and the working alliance. The Social Cognition and Object Relations Scale (SCORS; Westen, 1991), an object relations scoring system for the TAT, was used to assess object relations functioning. Forty-eight therapy clients at a university-based training clinic were administered the TAT, Adult Attachment Scale (AAS), Symptom Checklist 90-Revised (SCL-90-R; Derogatis, 1977), and the short form of the Marlowe-Crowne Social Desirability Scale (MCSD; Crowne & Marlowe, 1960). Following the initial assessment of client characteristics shortly after intake, clients and their therapists rated the working alliance 3 sessions later. Results indicated that the SCORS was significantly correlated with client and therapist ratings of the working alliance. The current study also assessed the predictive validity of the SCORS by examining how its various scales are related to aspects of the working alliance and the other measures used in this study. The findings suggest that the relationship between object relations functioning, the working alliance, symptom severity, and attachment disturbance depends on the aspect of object relations that is being assessed.

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Galon, Caroline. "Trauma-informed dance movement psychotherapy : understanding the therapeutic process and its components." Thesis, Edge Hill University, 2019. http://repository.edgehill.ac.uk/11097/.

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The adverse and lasting effects traumatic experiences can have on individuals pose significant challenges to psychotherapeutic treatments. This is due to the profound impact trauma has on the body and mind of survivors which can result in a wide range of posttraumatic symptoms, The unique nature of traumatic memories, and the extent to which they can become engrained, can further complicate treatment considerations. Relevant literature suggests that Dance Movement Psychotherapy (DMP) can be useful for treating survivors of trauma, due to its emphasis on embodiment and creativity that this modality offers. However, research to support this notion is currently limited. Furthermore, not enough is known about how the therapeutic process with survivors of trauma unfolds in the context of DMP. This thesis, therefore, aimed to identify the components of the therapeutic processes used in trauma-informed DMP as a step towards improving understanding of therapeutic practice with this client group. This thesis used hermeneutic phenomenology as the underlying methodology and epistemological position from which all findings and understandings were derived. It encompassed the following two strands: the first involved semi-structured interviews with practitioners who were experienced in treating survivors of trauma. To ensure a sufficient amount of data were collected, and due to commonalities between the DMP and Body Psychotherapy (BP) modalities with regards to the role of the body in the therapeutic process, participants from both of these professions were interviewed for the first research component. The second strand comprised a heuristic inquiry that utilised embodied and creative practice to synthesise the findings from the first strand, and elucidate further the components of the therapeutic process. Findings suggest that the therapeutic process for treating trauma comprises of several identifiable therapeutic elements, some of which were grounded in embodiment and creativity and appeared to be specific to DMP. A relationship was found between the concepts of "narrative‟, "trauma-processing‟ and "ritual‟ while the notion of "joy‟ was identified as ii supporting and signifying positive change. Concepts of "witnessing‟ and "resourcing‟ were also identified. These were perceived by respondents to facilitate and support the therapeutic process with this client group. Applied embodiment and creativity were found to be empowering and seen to facilitate a manageable and paced access to traumatic material. The synthesised results of this thesis are presented as a map of the therapeutic process, and it is suggested that findings may potentially be transferable and useful for other treatment modalities. Overall, the results of this thesis enabled a fuller understanding of the role DMP can play in facilitating therapeutic processes with this client group. Furthermore, the current findings emphasise the contribution that DMP can make to the wider body of knowledge relating with psychotherapeutic treatment approaches to trauma.

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Amézaga, Avitia Ana Cristina. "Expectations regarding psychotherapy and therapeutic alliance in women with depression : a study in two different cultural contexts." Tesis, Universidad de Chile, 2014. http://repositorio.uchile.cl/handle/2250/145069.

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The objective of the present study is to determine the relationship between psychotherapy expectations and early therapeutic alliance (first and third session) in women with depression in different cultural contexts (Chile and Germany), exploring the association between these variables and specific cultural variables such as dependent/interdependent self-construal, traditional/egalitarian sex role ideology, and the rigidity/laxness of social and familial norms. The sample consists of two groups of patients receiving psychotherapy, one in Chile and another in Germany. The first group is made up by 46 women diagnosed with depression, while the other consists of 30 female participants with the same diagnosis. The participants' age ranges between 20 and 50 years. The Chilean participants were contacted at Psicomédica, an outpatient mental health center in Santiago. They were receiving treatment which followed different theoretical psychotherapeutic approaches, once a week. The German women were recruited at the General and Psychosomatic Medicine Clinic (Heidelberg University Hospital), where they received inpatient treatment with a psychodynamic approach in two weekly sessions. The participants' level of depression was measured with the Beck Depression Inventory BDI-I (Beck, Ward, Mendelson, Mock & Erbaugh, J., 1961) both in Chile and Germany (Hautzinger, Bailer, Worall & Keller, 1994 [BDI-I]), before the first session. Also, a clinical interview was implemented in Chile, the MINI International Neuropsychiatric Interview (Lecubrier, Sheehan, Weiller, Amorim, Bonora, Sheehan, Janavs & Dunbar, 1997), while in Germany the Patient Health Questionnaire of Depression PHQ-D (Spitzer, Kroenke & Williams 1999) was used. Patient expectations were measured with the Patient Expectations Evaluation PATHEV (Schulte, 2005) in Chile and Germany, before beginning the psychotherapeutic process. Cultural variables were measured with the same questionnaire battery in both countries: the Multidimensional Cultural Variables Questionnaire for Chile (Olhaberry, Crempien, Biedermann, Cruzat, Martínez, V., Martínez, F. & Krause, 2011 [CMVC]) and the 9 Battery of Multidimensional Cultural Variables (Freund, Zimmermann, Pfeiffer, Conradi, Hunger, Riedel, Boysen, Schwinn, Rost, Cierpka, & Kämmerer, 2010 [HKFB]) for Germany. The therapeutic alliance was measured with the Working Alliance Inventory, WAI (Santibañez, 2001), in Chile and WAI-SR (Wilmers, Munder, Leonhart, Herzog, Plassmann, Barth, & Linster, 2008) in Germany, after the first and third sessions. Concerning the results of the comparison, significant differences between Chile and Germany were found in specific cultural variables (dependent and interdependent self-concept, social norms, sexual role ideology) and the therapeutic alliance as measured in sessions 1 and 3 (A1 and A3). In Chile, a positive association was observed between expectations and the alliance of session 1 (A1) but not with that of session 3 (A3). In Germany, expectations displayed a positive association with the alliance of session one (A1) and that of session three (A3). Regarding the relationship between cultural variables and the alliance, a positive association between independent self construal and A1 was found in Chile. In Germany, a positive association was observed between interdependent self-construal and A1; in addition, the egalitarian sex role ideology displayed a positive association with A1. Based on the results analyzed in both countries, it can be concluded that no significant association is present in the relationship between expectations and cultural variables. Likewise, no significant association was found in Chile and Germany between depression levels and expectations, nor was a link discovered between specific cultural variables and depression levels and the therapeutic alliance (A1 and A3).

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Fitzpatrick, Marilyn. "The working alliance, therapist interventions, client experiencing, and client good moments : a psychotherapy process study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ36976.pdf.

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Jindal, Meetika Ketring Scott A. "Amount and quality of supervision as moderating factors between couple therapeutic alliance and change in couple therapy." Auburn, Ala., 2005. http://repo.lib.auburn.edu/2005%20Fall/Thesis/JINDAL_MEETIKA_48.pdf.

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Ji, Peter Yun. "The role of attachment status in predicting longitudinal relationships between session-impact events and the working alliance within an adolescent client population /." free to MU campus, to others for purchase, 2001. http://wwwlib.umi.com/cr/mo/fullcit?p3036835.

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Soto, Alberto. "A Meta-Analytic Review of the Association of Therapeutic Alliance, Therapist Empathy, Client Attachment Style, and Client Expectations with Client Outcome." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6493.

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The therapeutic alliance has consistently been associated with improved client outcomes across numerous psychotherapy outcome studies. Previous systematic reviews have, however, evaluated the univariate association of the alliance with client outcome. The present meta-analytic review examines the association of the alliance with improved client outcomes after accounting for the presence of therapist empathy, client attachment styles, and client expectations. Across 23 independent studies, the alliance, adjusted for the presence of the other variables, remained as the most robust predictor of improved outcomes r = .258 (SE = .01, p < .001), with a 95% confidence interval of r = .18 to r = .33. After accounting for therapeutic alliance, therapist empathy was a small but statistically significant predictor of improved outcomes. These findings provide the first attempt at synthesizing multivariate estimates of the contribution of the alliance with improved outcomes when in the presence of empathy, client attachment style, and client expectations. The findings presented here suggest the superordinate nature of the alliance as a variable that exists on a separate conceptual level from the other variables evaluated.

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Chao, Wentao. "Tracking the movement of therapeutic change process a qualitative analysis of therapy with Taiwan families /." Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/hkuto/record/B3852305X.

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Hawks, Jillian M. "Exploring the Therapeutic Alliance with Adolescents and Their Caregivers: A Qualitative Approach." UKnowledge, 2015. http://uknowledge.uky.edu/hes_etds/32.

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The therapeutic alliance is largely recognized as an important component of the therapeutic process. For clients of all ages, the therapeutic alliance has been associated with positive outcomes and increased engagement in therapy (Bachelor, 2013; Bhola, & Kapur, 2013; Liber et al., 2010). However, very few studies have explored the complex process of fostering the therapeutic alliance with adolescent clients, while also maintaining a positive therapeutic relationship with the adolescent’s caregivers. The present study attempted to fill the gap in the literature through qualitatively exploring therapists’ perspectives of the therapeutic alliance with adolescents and their caregivers. In order to discover the essence of therapists’ experiences of the therapeutic alliance with adolescents and their caregivers, a phenomenological research design was employed. Nine therapists were interviewed about their experiences of the therapeutic alliance with adolescents and their caregivers. The interviews were transcribed and analyzed, and various themes and subthemes were revealed. The themes were divided into three sections: (1) conceptualizing the therapeutic alliance, (2) therapeutic alliance with adolescents, and (3) therapeutic alliance with caregivers. Two themes emerged within the ‘conceptualizing the therapeutic alliance’ section: (1) trust, and (2) foundation of therapy. Two themes and various subthemes emerged within the ‘therapeutic alliance with adolescents’ section. The first theme describes the obstacles that therapists face when attempting to build the alliance with adolescent clients, and contained three subthemes: (1) viewed as an authority figure, (2) resistance to therapy, and (3) differences in SES. The second theme describes the strategies that therapists use to develop the therapeutic alliance and contains three subthemes: (1) discuss interests, (2) honor their voice, and (3) describe limits of confidentiality. Two themes were unveiled within the ‘therapeutic alliance with caregivers’ section: (1) obstacles, and (2) strategies. The ‘obstacles’ theme describes barriers that therapists face when constructing the alliance with caregivers of adolescent clients, and contains two subthemes: (1) fear of triangulation, and (2) caregivers’ expectations. The ‘strategies’ theme contains four subthemes: (1) empathy, (2) give caregivers an active role, (3) collaborative approach, and (4) establish clear boundaries. Clinical implications, recommendations for future research, and limitations of the study are discussed.

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Hogan, Lindsey R. "The Role of Values in Psychotherapy Process and Outcome." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc804912/.

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Given the importance of client characteristics and preferences, and therapist expertise to evidence-based practice in psychology, the current study sought to contribute to the literature concerning the role of values in psychotherapy. Personal values of clients and trainee therapists in 29 dyads were examined for relationships between client and therapist values and associations with working alliance and outcomes. Although previous literature in this area has suggested that successful therapy is characterized by an increase in similarity of client and therapist values, the current study did not replicate this finding. However, client perceptions of therapist values were found to be important to working alliance and outcome. Findings are discussed in terms of suggestions for future research as well as implications for clinical practice, including the importance of discussing expectations and preferences with clients.

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Dissertations / Theses on the topic 'Therapeutic alliance, psychotherapy process'

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