Bergin and Garfield's Handbook of Psychotherapy and Behavior Change by Michael J. Lambert

Author:Michael J. Lambert
Language: eng
Format: epub, pdf
Publisher: Wiley
Published: 2013-01-01T16:00:00+00:00

Early Gains

There have been some noteworthy challenges to the interpretation of the alliance-outcome correlation. A number of studies have examined the relationship between early treatment gains and alliance with some finding the former carries the predictive load. In other words, it has been suggested that the alliance itself could simply be a product of earlier changes in symptoms. Several studies have failed to demonstrate that the alliance predicts subsequent symptom change when controlling for early treatment gains (Barber et al., 1999; Barber et al., 2001; DeRubeis & Feeley, 1990; Feeley, DeRubeis, & Gelfand, 1999; Strunk, Brotman, & DeRubeis, 2010). Several other studies, however, have still found that the alliance is predictive of outcome above and beyond the impact of early gains (e.g., Barber, Connolly, Crits-Christoph, Gladis, & Siqueland, 2000; Brottman, 2004; Constantino, Arnow, Blasey & Agras, 2005; Gaston et al., 1991; Klein, Schwartz, et al., 2003; Strauss et al., 2006). The lack of convergence in the literature reflects the complexity of the alliance construct and the need for further research in this regard.

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