The Role of the Therapeutic Alliance in Psychotherapy Pharmacotherapy Outcome Findings in the National Institute Of Mental Health Treatment of Depression Collaborative Research Program

• Published in: Journal of consulting and clinical psychology Vol. 64; no. 3; pp. 532 - 539
• Main Authors: Krupnick, Janice L, Sotsky, Stuart M, Simmens, Sam, Moyer, Janet, Elkin, Irene, Watkins, John, Pilkonis, Paul A
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-06-1996
• Subjects: Adult; Adults; Antidepressive Agents, Tricyclic - therapeutic use; Biological and medical sciences; Cognitive Behavioral Therapy - methods; Cognitive behaviour therapy; Combined Modality Therapy; Comparison; Counseling Effectiveness; Depression; Depression (Psychology); Depressive Disorder - psychology; Depressive Disorder - therapy; Drug Therapy; Female; Human; Humans; Imipramine; Imipramine - therapeutic use; Major Depression; Male; Medical sciences; Mental depression; National Institute of Mental Health; Outcomes; Outcomes of Treatment; Outpatient Care; Patients; Person-Centered Psychotherapy - methods; Personality Assessment; Pharmacology; Pharmacotherapy; Professional relationships; Professional-Patient Relations; Psychiatry; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Role; Therapeutic Alliance; Therapeutic alliances; Therapeutic Environment; Therapeutical relation and framework; Therapy; Treatment Outcome; Treatment Outcomes; Treatments; Varimax Procedures; Human; Mood disorder; Cognitive therapy; Psychotropic; Treatment efficiency; Psychotherapy; Depression; Tricyclic compound; Therapeutic relation; Chemotherapy; Adult; Antidepressant agent; Behavior therapy; Comparative study
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/0022-006X.64.3.532

The relationship between therapeutic alliance and treatment outcome was examined for depressed outpatients who received interpersonal psychotherapy, cognitive-behavior therapy, imipramine with clinical management, or placebo with clinical management. Clinical raters scored videotapes of early, middle, and late therapy sessions for 225 cases (619 sessions). Outcome was assessed from patients' and clinical evaluators' perspectives and from depressive symptomatology. Therapeutic alliance was found to have a significant effect on clinical outcome for both psychotherapies and for active and placebo pharmacotherapy. Ratings of patient contribution to the alliance were significantly related to treatment outcome; ratings of therapist contribution to the alliance and outcome were not significantly linked. These results indicate that the therapeutic alliance is a common factor with significant influence on outcome.