62600
document
Does alliance predict symptoms throughout treatment , or is it the other way around ? OBJECTIVE Scholars increasingly recognize that therapeutic alliance and symptomatic change are associated with one another . A common assumption is that alliance predicts symptomatic change . However , the issue is far from settled . One challenge in determining the causality is the establishment of temporal precedence showing that alliance , as opposed to previous symptomatic change , drives subsequent symptomatic reduction . METHOD To make further advances in untangling this chicken-and-egg question , we employed autoregressive cross-lagged modeling over 4 time points in a sample of 149 depressive patients receiving supportive-expressive psychotherapy or clinical management combined with pharmacotherapy or clinical management combined with placebo . RESULTS Using this methodology , we found that both alliance and symptoms across treatment made significant and unique contributions in predicting subsequent symptomatic levels throughout treatment . Additionally , alliance , but not symptoms , predicted subsequent alliance levels . No differences were found between treatments . CONCLUSIONS Our findings imply that alliance temporally precedes symptomatic levels throughout treatment .
62601
Intervention_Psychological
supportive-expressive psychotherapy
62602
Intervention_Psychological
clinical management combined with pharmacotherapy
62603
Intervention_Control
clinical management combined with placebo
62604
Outcome_Physical
alliance predict symptoms
62605
Outcome_Physical
therapeutic alliance and symptomatic change
62606
Outcome_Physical
alliance predicts symptomatic change .
62607
Outcome_Physical
symptomatic reduction .
62608
Outcome_Physical
alliance and symptoms
62609
Outcome_Physical
contributions
62610
Outcome_Physical
predicting subsequent symptomatic levels
62611
Outcome_Physical
alliance
62612
Outcome_Physical
subsequent alliance levels .
62613
Outcome_Physical
alliance
62614
Outcome_Physical
symptomatic levels