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Therapists and People in Therapy Perceive Outcomes Differently


There are many different components to successful therapy. One of the core elements that can predict productive and meaningful therapy is a strong therapeutic alliance. The relationship between the therapist and client is built on trust and competence and provides the foundation from which change can occur. For women who face the challenges of cancer, developing a bond with a therapist is an essential step forward in recovery. The alliance creates an environment of acceptance and willingness that empowers a woman with the skills she needs to combat the negative psychological results of cancer, such as loneliness, isolation, anxiety, fear, and depression.

Sharon L. Manne of the Cancer Prevention and Control Program at the Cancer Institute of New Jersey realizes the importance of the therapeutic bond and has conducted research on this critical component of therapy. She has previously found that communication and counseling provide significant mental health benefits for women. But until recently, Manne had not explored how therapists and clients view the therapeutic bond and their progress in sessions designed to alleviate the mental health symptoms associated with cancer. Therefore, Mann recently followed 203 women undergoing 6 weeks of therapy for cancer distress. She evaluated the women’s levels of depression, emotional responsiveness, and self-esteem before and after the treatment. She also had the therapists and clients rate their perception of therapeutic alliance and progress during the treatment.

Manne discovered that alliance was subjective, except in cases in which the therapist identified robust relationships. In those cases, therapists and clients were in agreement with respect to the strength of alliance. However, in most other reports, clients rated the alliance as strong and therapists rated it weak. Manne also found that the most experienced therapists were more likely to report higher levels of alliance and progress than less experienced therapists. Another key finding was the rate of progress as reported by the clients. In particular, the clients with the highest levels of psychological stress reported the lowest levels of therapeutic alliance but the most significant gains in progress. Manne said, “Thus, although alliances remained lower among distressed patients, they improved over the course of therapy.” Taken together, these findings suggest client and therapist perception are significant to treatment outcome and should be examined further in future studies.

Manne, S. L., Kashy, D. A., Rubin, S., Hernandez, E., Bergman, C. (2012). Therapist and patient perceptions of alliance and progress in psychological therapy for women diagnosed with gynecological cancers. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029158

Related articles:
Good Communication Skills and Cancer
Managing Fear and Uncertainty while Living with Cancer
How To Fight Cancer With Social Support

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  • Karey July 31st, 2012 at 6:18 PM #1

    I think in any relationship thte alliance between partners is really indicative of the success of the relationship. If the partners are in lock step and moving forward I think overall there is a great positive feeling that emminates forward driving the relationship to a successful conclusion.

  • Jamie July 31st, 2012 at 6:39 PM #2

    I cannot stress enough about how important an alliance with your therapist is.My therapist almost single-handedly turned things around for me.i was thinking of ending my life two years ago and today I’m in love with life.I have my therapist to thank for a major part of it.

  • B.L August 1st, 2012 at 3:01 PM #3

    “the clients with the highest levels of psychological stress reported the lowest levels of therapeutic alliance but the most significant gains in progress.”

    I think why this happens is because high stress patients cannot really judge the level of the alliance.it is supported by the fact that they gained progress,which is almost impossible without a good alliance with their therapist.

    also,experienced therapists exhibiting higher levels of alliance is good news.so when we need a therapist we know which ones are a better bet.

  • Karl August 5th, 2012 at 9:41 AM #4

    Doesn’t it seem odd that two people in the same room together for an extended period of time and for a length of time that has been suitable for therapy could have such vastly different views of how strong the alliance is and how successful that the therapy has been too? You would hope, I would think, for more comparable findings, and that this would show more success.

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