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The Influence of Trauma Symptoms on the Therapeutic Alliance Across Treatment
Author(s) -
Lawson David M.,
Skidmore Susan Troncoso,
AkaySullivan Sinem
Publication year - 2020
Publication title -
journal of counseling and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 78
eISSN - 1556-6676
pISSN - 0748-9633
DOI - 10.1002/jcad.12297
Subject(s) - alliance , interpersonal communication , psychology , clinical psychology , dissociation (chemistry) , interpersonal relationship , psychotherapist , psychiatry , social psychology , chemistry , political science , law
The authors examined the influence of early phase dissociation, interpersonal problems, and retraumatization on the therapeutic alliance at early, middle, and later treatment phases. Participants were 84 female survivors of child abuse (ages 18 to 60 years, 53.6% Caucasian) who were receiving counseling at a university training clinic. Master’s‐ and doctoral‐level students provided counseling using integrated relationship and trauma‐based cognitive behavior therapy. Treatment followed a 3‐phase model. The authors used structural equation models to test the hypothesis. In the early and later phases, fewer interpersonal problems significantly predicted a stronger alliance. In the middle phase, fewer interpersonal problems, less dissociation, and more revictimization significantly predicted a stronger alliance. Tasks, goals, and bond contributed significantly to the alliance in each of the 3 phases. Interpersonal problems were consistently the strongest predictor across the 3 phases, whereas tasks consistently made the greatest contribution to the therapeutic alliance across all 3 phases.