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The Relationship Between Therapeutic Alliance, Early Symptom Change, and Outcome Among In‐Patients With Anorexia Nervosa.

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Title: The Relationship Between Therapeutic Alliance, Early Symptom Change, and Outcome Among In‐Patients With Anorexia Nervosa.
Authors: Werz, Janina (AUTHOR), Tuschen‐Caffier, Brunna (AUTHOR), Voderholzer, Ulrich (AUTHOR)
Source: International Journal of Eating Disorders. Dec2025, Vol. 58 Issue 12, p2378-2391. 14p.
Subjects: Anorexia nervosa treatment, Self-evaluation, Scale analysis (Psychology), Statistical power analysis, Body mass index, T-test (Statistics), Questionnaires, Interviewing, Termination of treatment, Fisher exact test, Multiple regression analysis, Logistic regression analysis, Treatment effectiveness, Disease remission, Chi-squared test, Descriptive statistics, Age distribution, Motivation (Psychology), Anorexia nervosa, Therapeutic alliance, Cognitive therapy, Regression analysis, Weight gain, Nosology, Health care teams
Geographic Terms: Germany
Abstract: Objective: Therapeutic alliance (TA) is an important process variable, evidence suggesting its influence on treatment outcome across several mental disorders. Yet, its role in treating anorexia nervosa (AN) remains under‐examined. Previous research has yielded heterogeneous results, indicating a complex relationship between TA, early change, and outcome, potentially depending on contributing factors like age. This relationship was examined in a sample of 173 adult and adolescent inpatients with AN treated in a specialized clinic. Method: Data were collected in weeks 2, 5, 9, and the week before discharge. Outcome was defined dimensionally (Eating Disorder Examination Questionnaire, Body Mass Index) and categorically (premature termination, weight status, remission status). Several potential influencing factors (e.g., duration of illness, previous therapy) were analyzed. The effect of TA on early change and outcome, and vice versa, was analyzed using regression analyses. Results: TA was positively associated with greater early weight gain and overall general symptom change. Later TA predicted premature termination and remission status. The latter effect ceased when early change was considered. The TA subscale "task" played the most important role. Early change in ED symptoms predicted better TA later in treatment. Discussion: In accordance with previous research, a complex bidirectional relationship between TA and outcome in AN patients was identified. The results indicate the importance of focusing on symptom improvement as well as establishing an agreement on therapeutic tasks. Future research should concentrate on the complexity and bidirectionality of TA and symptom change over the course of treatment, considering possible mediators. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Eating Disorders 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: The Relationship Between Therapeutic Alliance, Early Symptom Change, and Outcome Among In‐Patients With Anorexia Nervosa.
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  Data: <searchLink fieldCode="AR" term="%22Werz%2C+Janina%22">Werz, Janina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tuschen‐Caffier%2C+Brunna%22">Tuschen‐Caffier, Brunna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Voderholzer%2C+Ulrich%22">Voderholzer, Ulrich</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Eating+Disorders%22">International Journal of Eating Disorders</searchLink>. Dec2025, Vol. 58 Issue 12, p2378-2391. 14p.
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  Data: <searchLink fieldCode="DE" term="%22Anorexia+nervosa+treatment%22">Anorexia nervosa treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Self-evaluation%22">Self-evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Scale+analysis+%28Psychology%29%22">Scale analysis (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+power+analysis%22">Statistical power analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Body+mass+index%22">Body mass index</searchLink><br /><searchLink fieldCode="DE" term="%22T-test+%28Statistics%29%22">T-test (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Termination+of+treatment%22">Termination of treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Fisher+exact+test%22">Fisher exact test</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+regression+analysis%22">Multiple regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+remission%22">Disease remission</searchLink><br /><searchLink fieldCode="DE" term="%22Chi-squared+test%22">Chi-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Age+distribution%22">Age distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Motivation+%28Psychology%29%22">Motivation (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Anorexia+nervosa%22">Anorexia nervosa</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+alliance%22">Therapeutic alliance</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+analysis%22">Regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Weight+gain%22">Weight gain</searchLink><br /><searchLink fieldCode="DE" term="%22Nosology%22">Nosology</searchLink><br /><searchLink fieldCode="DE" term="%22Health+care+teams%22">Health care teams</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Germany%22">Germany</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Therapeutic alliance (TA) is an important process variable, evidence suggesting its influence on treatment outcome across several mental disorders. Yet, its role in treating anorexia nervosa (AN) remains under‐examined. Previous research has yielded heterogeneous results, indicating a complex relationship between TA, early change, and outcome, potentially depending on contributing factors like age. This relationship was examined in a sample of 173 adult and adolescent inpatients with AN treated in a specialized clinic. Method: Data were collected in weeks 2, 5, 9, and the week before discharge. Outcome was defined dimensionally (Eating Disorder Examination Questionnaire, Body Mass Index) and categorically (premature termination, weight status, remission status). Several potential influencing factors (e.g., duration of illness, previous therapy) were analyzed. The effect of TA on early change and outcome, and vice versa, was analyzed using regression analyses. Results: TA was positively associated with greater early weight gain and overall general symptom change. Later TA predicted premature termination and remission status. The latter effect ceased when early change was considered. The TA subscale "task" played the most important role. Early change in ED symptoms predicted better TA later in treatment. Discussion: In accordance with previous research, a complex bidirectional relationship between TA and outcome in AN patients was identified. The results indicate the importance of focusing on symptom improvement as well as establishing an agreement on therapeutic tasks. Future research should concentrate on the complexity and bidirectionality of TA and symptom change over the course of treatment, considering possible mediators. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of International Journal of Eating Disorders 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.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=192268587
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/eat.24524
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 2378
    Subjects:
      – SubjectFull: Anorexia nervosa treatment
        Type: general
      – SubjectFull: Self-evaluation
        Type: general
      – SubjectFull: Scale analysis (Psychology)
        Type: general
      – SubjectFull: Statistical power analysis
        Type: general
      – SubjectFull: Body mass index
        Type: general
      – SubjectFull: T-test (Statistics)
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Interviewing
        Type: general
      – SubjectFull: Termination of treatment
        Type: general
      – SubjectFull: Fisher exact test
        Type: general
      – SubjectFull: Multiple regression analysis
        Type: general
      – SubjectFull: Logistic regression analysis
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Disease remission
        Type: general
      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Motivation (Psychology)
        Type: general
      – SubjectFull: Anorexia nervosa
        Type: general
      – SubjectFull: Therapeutic alliance
        Type: general
      – SubjectFull: Cognitive therapy
        Type: general
      – SubjectFull: Regression analysis
        Type: general
      – SubjectFull: Weight gain
        Type: general
      – SubjectFull: Nosology
        Type: general
      – SubjectFull: Health care teams
        Type: general
      – SubjectFull: Germany
        Type: general
    Titles:
      – TitleFull: The Relationship Between Therapeutic Alliance, Early Symptom Change, and Outcome Among In‐Patients With Anorexia Nervosa.
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            NameFull: Werz, Janina
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            NameFull: Tuschen‐Caffier, Brunna
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            NameFull: Voderholzer, Ulrich
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            – D: 01
              M: 12
              Text: Dec2025
              Type: published
              Y: 2025
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              Value: 58
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            – TitleFull: International Journal of Eating Disorders
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