The interaction of the alliance and therapy microprocess: A sequential analysis

Author(s): Hembre, K., Kvarme, G.

Journal/Book: J Consult Clin Psychol. 1996; 64: 750 First St NE, Washington, DC 20002-4242. Amer Psychological Assoc. 471-480.

Abstract: The interaction of the working alliance with the therapy microprocess was explored in a sequential analytic study of brief therapy (N = 32). The alliance was largely formed within the first session and was most associated with a mutual emotional engagement process. Thereafter, log-linear modeling revealed marked alliance-related and primarily phase-specific effects on the therapy microprocesses. The alliance was associated with differing patterns of therapy activities, topics, emotions, and verbal content. High-alliance midtherapy displayed more of an alternating pattern of therapist-patient emotional engagement, although therapists also appeared to take greater charge in midtherapy. High-alliance patients were generally more emotionally engaged and responded with less dejection to therapists. The alliance-dependent differences in verbal content appeared to be secondary, with the most obvious negative effects of low-alliance levels appearing in midtherapy. Apparently, the high- and low-alliance therapies developed somewhat differently, a factor that may need to be considered in constructing theories of therapeutic change.

Note: Article HC Sexton, Finnmark & Troms, Psychiatr Res Ctr, Asgard Hosp, N-9016 Tromso, Norway

Keyword(s): PSYCHOTHERAPY; POWER

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