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
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