Patient's interpersonal problems and early alliance negotiation as predictors of therapeutic change

GÓMEZ PENEDO, JUAN MARTÍN; DORAN, JENNIFER; ROUSSOS, ANDRÉS J.

Jerusalem

Congreso; 48th annual meeting of the SPR; 2016

SPR

Aims: The present paper analyzes the relationship among patient's interpersonal problems, early alliance negotiation and psychotherapy change. Methods: Fifty-eight patients diagnosed with emotional disorders completed the Inventory of Interpersonal Problems (IIP) at baseline, and the Alliance Negotiation Scale (ANS) and the Outcome Questionnaire.45 (OQ.45) after each of the first four sessions of a cognitive-integrative psychotherapy. Twenty five participants completed the OQ.45 and the IIP after treatment ́s termination. Results: Baseline cold-submissiveness interpersonal problems predicted lower scores in ANS, particularly in the factor comfort with negative feelings (r = .232; p = .040). Early alliance negotiation predicted gains in OQ.45 at treatments termination (r = .430, p = .018) but not early gains (r = .073; p = .293). Therapist's negotiable stance and flexibility predicted changes in interpersonal agency (r = .571; p = .001), reducing problems in being socially avoidant (r = .444; p = .013) and exploitable (r = .467; p = .009). Discussion: When a higher flexibility and negotiable posture was observed in the therapist, the patients solved problems of submissiveness exercising more control over other people. Higher alliance negotiation was also related to symptomatic improvement. Results presented initial evidence to hypothesize alliance negotiation as an eventual mechanism of change in psychotherapy.