Consensus on Alliance Quality in the Psychotherapeutic Dyad and Its Differentiating Effect on Treatment Outcomes in Patients with Adjustment Disorders

Abstract

The study aimed to analyze patient–therapist convergence in therapeutic alliance ratings. The author also tested if increasing patient–therapist consensus on alliance quality during psychotherapy was related to better treatment outcomes. The study included 20 patients and one psychotherapist, who was a person other than the researcher in this study. The patients, suffering from adjustment disorders, were undergoing individual outpatient treatment in private practice. Three estimations of alliance and two estimations of treatment outcomes were performed. Psychotherapeutic processes, lasting nearly a year and a half, were examined from their commencement to their natural completion. The hypotheses were verified using difference tests. Two-dimensional correlations were computed, and the outcomes of psychotherapy were estimated using a clinical significance index. The results revealed systematic patient–therapist discrepancies in alliance quality ratings at specific time points and the psychotherapist’s tendency to underrate alliance quality. Patient–therapist convergence in therapeutic alliance perceptions increased over the course of psychotherapy. The expected differences in treatment outcomes depending on convergence in alliance quality ratings were not found. Analysis results indicate that, in psychotherapy for patients with adjustment disorders, patient and therapist evaluations of alliance diverge, particularly in the early phases of treatment. Increasing consensus on alliance quality is observed. Similar convergence in alliance ratings was found in adjustment disorder patients with better and worse treatment outcomes.