A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis
AbstractBackground:Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients’ and therapists’ estimations of TA among clients with...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2020-01-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382000067X/type/journal_article |
| _version_ | 1811156302091517952 |
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| author | Libby Igra Michal Lavidor Dana Atzil-Slonim Nitzan Arnon-Ribenfeld Steven de Jong Ilanit Hasson-Ohayon |
| author_facet | Libby Igra Michal Lavidor Dana Atzil-Slonim Nitzan Arnon-Ribenfeld Steven de Jong Ilanit Hasson-Ohayon |
| author_sort | Libby Igra |
| collection | DOAJ |
| description | AbstractBackground:Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients’ and therapists’ estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument.Method:We conducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substance misuse disorders. We then analyzed the data using a random-effects meta-analytic model with Cohen’s d standardized mean effect size.Results:Heterogeneity analyses (k = 22, Cohen’s d = −.46, 95% confidence interval = .31–1.1) produced a significant Q-statistic (Q = 94.96) and indicated high heterogeneity, suggesting that moderator analyses were appropriate.Conclusions:Our findings show that the type of TA instrument moderates the agreement on TA between client and therapist, but there was no indication of the client’s diagnosis moderating the effect. The agreement between client and therapist estimations seems to be dependent on the instrument that is used to assess TA. Specific setting-related instruments seem to result in higher agreement between clients’ and therapists’ estimations than do more general instruments that are applied to assess TA. |
| first_indexed | 2024-04-10T04:49:17Z |
| format | Article |
| id | doaj.art-582378fedc024029b722db7ac7dd478c |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-04-10T04:49:17Z |
| publishDate | 2020-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-582378fedc024029b722db7ac7dd478c2023-03-09T12:33:57ZengCambridge University PressEuropean Psychiatry0924-93381778-35852020-01-016310.1192/j.eurpsy.2020.67A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosisLibby Igra0https://orcid.org/0000-0002-1872-4539Michal Lavidor1Dana Atzil-Slonim2Nitzan Arnon-Ribenfeld3Steven de Jong4https://orcid.org/0000-0002-0421-3041Ilanit Hasson-Ohayon5Department of Psychology, Bar-Ilan University, Ramat Gan, IsraelDepartment of Psychology, Bar-Ilan University, Ramat Gan, IsraelDepartment of Psychology, Bar-Ilan University, Ramat Gan, IsraelDepartment of Psychology, Bar-Ilan University, Ramat Gan, IsraelLentis Psychiatric Institute, Lentis Research & FACT noord- Groningen, The NetherlandsDepartment of Psychology, Bar-Ilan University, Ramat Gan, IsraelAbstractBackground:Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients’ and therapists’ estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument.Method:We conducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substance misuse disorders. We then analyzed the data using a random-effects meta-analytic model with Cohen’s d standardized mean effect size.Results:Heterogeneity analyses (k = 22, Cohen’s d = −.46, 95% confidence interval = .31–1.1) produced a significant Q-statistic (Q = 94.96) and indicated high heterogeneity, suggesting that moderator analyses were appropriate.Conclusions:Our findings show that the type of TA instrument moderates the agreement on TA between client and therapist, but there was no indication of the client’s diagnosis moderating the effect. The agreement between client and therapist estimations seems to be dependent on the instrument that is used to assess TA. Specific setting-related instruments seem to result in higher agreement between clients’ and therapists’ estimations than do more general instruments that are applied to assess TA.https://www.cambridge.org/core/product/identifier/S092493382000067X/type/journal_articleAgreementmeta-analysistherapeutic alliance |
| spellingShingle | Libby Igra Michal Lavidor Dana Atzil-Slonim Nitzan Arnon-Ribenfeld Steven de Jong Ilanit Hasson-Ohayon A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis European Psychiatry Agreement meta-analysis therapeutic alliance |
| title | A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis |
| title_full | A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis |
| title_fullStr | A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis |
| title_full_unstemmed | A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis |
| title_short | A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis |
| title_sort | meta analysis of client therapist perspectives on the therapeutic alliance examining the moderating role of type of measurement and diagnosis |
| topic | Agreement meta-analysis therapeutic alliance |
| url | https://www.cambridge.org/core/product/identifier/S092493382000067X/type/journal_article |
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