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Within‐patient perceptions of alliance and attunement: Associations with progress in psychotherapy.

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Title: Within‐patient perceptions of alliance and attunement: Associations with progress in psychotherapy.
Authors: Aafjes‐van Doorn, Katie (AUTHOR), Bar‐Sella, Avigail (AUTHOR), Zilcha‐Mano, Sigal (AUTHOR), Luo, Xiaochen (AUTHOR), Silberschatz, George (AUTHOR), Kealy, David (AUTHOR), McCollum, James (AUTHOR), Snyder, John (AUTHOR)
Source: Clinical Psychology & Psychotherapy. Sep2022, Vol. 29 Issue 5, p1717-1727. 11p. 1 Chart.
Subjects: Sensory perception, Treatment effectiveness, Therapeutic alliance, Psychotherapy, Longitudinal method
Abstract: The most frequently examined aspect of the therapeutic relationship is the working alliance, which reflects the conscious collaborative bond, and agreement on task and goal. In addition to the established importance of the working alliance, the therapists' attunement and responsiveness might reflect another important aspect of the therapeutic relationship that can be considered in relation to session‐by‐session progress over treatments. Emerging research suggests that the quality of the working alliance not only differs between patients but also within patients over time. However, little is known about the quality of the therapeutic relationship between and within patients in relation to progress in psychotherapy. We examined fluctuations of the working alliance measure (WAI) and the newly developed measure of the Patients' Experiences of Attunement and Responsiveness (PEAR) during treatment in a naturalistic sample of patients in an outpatient psychotherapy clinic. Multilevel modelling was used to examine the respective contribution of these measures to subsequent improvement in psychological functioning longitudinally. Results suggest that the within‐patient effect, instead of between‐patient effect, was significant for WAI (and did not reach significance for PEAR), indicating that the fluctuation of WAI was predictive of psychological functioning in the subsequent month. Based on these findings, therapists and their patients might benefit from regular tracking of the patient‐reported working alliance. The findings underscore the importance of the alliance, specifically at the within‐patient level. It also highlights the challenge for research to tap into other aspects of the therapeutic relationship that can help explain progress in therapy. Given the breadth and accessibility of the working alliance construct, more work is needed for researchers to examine the construct of attunement and responsiveness. [ABSTRACT FROM AUTHOR]
Copyright of Clinical Psychology & Psychotherapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Within‐patient perceptions of alliance and attunement: Associations with progress in psychotherapy.
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  Data: <searchLink fieldCode="JN" term="%22Clinical+Psychology+%26+Psychotherapy%22">Clinical Psychology & Psychotherapy</searchLink>. Sep2022, Vol. 29 Issue 5, p1717-1727. 11p. 1 Chart.
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  Data: The most frequently examined aspect of the therapeutic relationship is the working alliance, which reflects the conscious collaborative bond, and agreement on task and goal. In addition to the established importance of the working alliance, the therapists' attunement and responsiveness might reflect another important aspect of the therapeutic relationship that can be considered in relation to session‐by‐session progress over treatments. Emerging research suggests that the quality of the working alliance not only differs between patients but also within patients over time. However, little is known about the quality of the therapeutic relationship between and within patients in relation to progress in psychotherapy. We examined fluctuations of the working alliance measure (WAI) and the newly developed measure of the Patients' Experiences of Attunement and Responsiveness (PEAR) during treatment in a naturalistic sample of patients in an outpatient psychotherapy clinic. Multilevel modelling was used to examine the respective contribution of these measures to subsequent improvement in psychological functioning longitudinally. Results suggest that the within‐patient effect, instead of between‐patient effect, was significant for WAI (and did not reach significance for PEAR), indicating that the fluctuation of WAI was predictive of psychological functioning in the subsequent month. Based on these findings, therapists and their patients might benefit from regular tracking of the patient‐reported working alliance. The findings underscore the importance of the alliance, specifically at the within‐patient level. It also highlights the challenge for research to tap into other aspects of the therapeutic relationship that can help explain progress in therapy. Given the breadth and accessibility of the working alliance construct, more work is needed for researchers to examine the construct of attunement and responsiveness. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Clinical Psychology & Psychotherapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: Sep2022
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