A time-series analysis of therapeutic alliance, interventions, and client's clinical status in an evidence-based single-case study: Evidence for establishing change mechanisms in psychotherapy

Psychother Res. 2018 Jan;28(1):137-149. doi: 10.1080/10503307.2016.1174346. Epub 2016 May 11.

Abstract

Objective: The goal of this study was to analyze the time-series of alliance, interventions, and client's post-sessions clinical status, to establish if alliance and adherence to cognitive-behavioral interventions preceded improvement in psychotherapy Method: A single-case study of a complete Cognitive-Behavioral treatment of a 27-year-old male diagnosed with Generalized Anxiety Disorder treatment was conducted. Alliance, adherence to cognitive-behavioral interventions, and client's therapeutic condition were assessed every two sessions during the entire treatment.

Results: After controlling for the effect of autocorrelations, the transfer functions showed that alliance predicted client's clinical condition with a lag of two sessions throughout the entire treatment. However, the inverse relationship was not observed.

Conclusions: Results support the hypothesis of a time-lagged association between alliance and subsequent client's changes in their clinical condition in single case of a cognitive-behavioral treatment.

Keywords: change; interventions; mechanism of change; single-case; therapeutic alliance.

MeSH terms

  • Adult
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Evidence-Based Practice / methods*
  • Humans
  • Male
  • Outcome and Process Assessment, Health Care / methods*
  • Professional-Patient Relations*
  • Psychotherapeutic Processes*