New paper out: Therapeutic Bond Judgments: Congruence and Incongruence
New paper out from our lab was accepted for publication in the Journal of Consulting and Clinical Psychology. This paper, entitled "Therapeutic Bond Judgments: Congruence and Incongruence" is a product of a fruitful collaboration with the Trier University Outpatient Clinic in Southwest Germany, and it was authored by Dana Atzil-Slonim, Eran Bar-Kalifa, Eshkol Rafaeli, and Tuvia Peri from Bar-Ilan Univarsity, and Wolfgang Lutz, Julian Rubel, and Ann-Kathrin Schiefele from University of Trier.
Here's the summary paragraph of that paper:
The present study had two aims: (a) to implement West and Kenny’s (2011) Truth-and-Bias model to simultaneously assess the temporal congruence and directional discrepancy between clients’ and therapists’ ratings of the bond facet of the therapeutic alliance, as they co-fluctuate from session to session; (b) to examine whether symptom severity and a personality disorder (PD) diagnosis moderate congruence and/or discrepancy. Method: Participants included 213 clients treated by 49 therapists. At pretreatment, clients were assessed for a PD diagnosis and completed symptom measures. Symptom severity was also assessed at the beginning of each session, using client self-reports. Both clients and therapists rated the therapeutic bond at the end of each session. Results: Therapists and clients exhibited substantial temporal congruence in their session-by-session bond ratings, but therapists’ ratings tended to be lower than their clients’ across sessions. Additionally, therapeutic dyads whose session-by-session ratings were more congruent also tended to have a larger directional discrepancy (clients' ratings being higher). Pretreatment symptom severity and PD diagnosis did not moderate either temporal congruence or discrepancy at the dyad level; however, during sessions when clients were more symptomatic, therapist and client ratings were both farther apart and tracked each other less closely. Conclusions: Our findings are consistent with a "better safe than sorry" pattern, which suggests that therapists are motivated to take a vigilant approach that may lead both to underestimation and to attunement to fluctuations in the therapeutic bond. Public health significance statement: This study advance the idea that therapists who adopt a vigilant approach may be more attuned to their clients’ changing experience. Additionally it highlights the risk of misattributing symptomatic change to factors within the therapeutic relationship.
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