“The alliance, typically defined as the client and therapist agreement on the goals and tasks of therapy and the development of a therapeutic bond, is consistently found to be a robust predictor of therapy success,” said Christoph Flückiger, Department of Clinical Psychology and Psychotherapy, at the University of Bern, Switzerland and lead author of a new study examining the effects of feedback on therapeutic outcome. “Especially in a remediation phase of therapy during which therapy is focused on actively changing clients’ problems/disorders, challenges to the alliance are common. Therapists often focus on deeper issues that are painful and/or threatening to the client; and maintenance of a collaborative therapeutic relationship and prevention of a lasting breakdown is crucial for therapeutic work.”
Experts believe that the feedback intervention theory (FIT), which is founded on the client’s ability to provide constructive and meaningful feedback to a therapist, is beneficial to goal attainment during treatment. In order to test this theory, Fluckiger and his colleagues interviewed 94 clients from an outpatient clinic in Switzerland. The clients had been enrolled in 24 sessions of therapy and were encouraged to give feedback of treatment experience to a neutral third party several times during the therapy. “The results indicated that the introduction of a brief meta-communication intervention at an institutional level (valuing client’s perspective) reinforced clients’ global alliance with their therapists over the course of therapy,” said the team. They added that although this approach is still rather unconventional, it is quite effective and should be considered by clinicians. “The implementation of this short adjunctive instruction was not time-consuming or expensive in comparison to other interventions that involves training therapist,” they said. “The results indicate that interventions, even brief or subtle, can produce lasting benefits in the alliance when targeted at specific psychological processes. Systematic meta-communication from the institutional level appeared to reinforce clients’ therapeutic alliance with their therapists in individual treatment.”
Flückiger, C., Del Re, A., Wampold, B. E., Znoj, H., Caspar, F., & Jörg, U. (2011, May 23). Valuing Clients’ Perspective and the Effects on the Therapeutic Alliance: A Randomized Controlled Study of an Adjunctive Instruction. Journal of Counseling Psychology. Advance online publication. doi: 10.1037/a0023648
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