"%2*6:0%0*70!
")!Z#2(!0c(0*(!$6!2<<$2*70!2::07(0&!34!(%2*6:0%0*70n!=*!091$%$72
O$*D0%_!R>_!p$<7#2E@2*)_!Q>_!@782%(#4_!I>!Q>_!F2%%0((_!@>!Q>_!G!F2%30%_!i>!/>![+,-P^>!;*(0%10%6)*2! N">#+@B&"!&/!!%?,)<%&;)("#*%#(O&IJIO& b,,hb,P>!! p$<7#2E@2*)_!Q>_!@782%(#4_!I>!Q>_!O$*D0%_!R>_!G!F2%30%_!i>!/>![+,-]_!@24!+g^>!")!Z#2(!0c(0*(!;6!2<<$2*70!2::07(0&! 34!(%2*6:0%0*70n!=*!091$%$72! '(A?-",-%#@:A >!=&Y2*70!)*<$*0!1B3<$72($)*>! #((1?uu&c>&)$>)%Du-,>-,Pdu2,,Pg.gg! >-001(3 ! Will patients project their representations of significant others onto the therapist in a way that influences the formation of the therapeutic alliance? To address this issue, the current study explored the following questions: (1) To what extent are pretreatment representations of others projected onto the therapist and thereby predict the development of alliance throughout the course of treatment? (2) To what extent are these projections affected by the real relationship? (3) Are there specific representations of others that are more prone to be projected onto the alliance? To this end, data on 134 patients from a randomized controlled trial for depression comparing dynamic supportive– expressive therapy with supportive clin- ical management combined with pharmacotherapy or placebo were used. Findings demonstrated that the patients’ pretreatment representations of significant others predicted a substantial part of the alliance with the therapist throughout the course of treatment. However, the representations of others were not automatically projected onto the alliance but rather the projections were also influenced by the real relationship with the therapist. Throughout this process, the alliance evolves into a collage of significant others. A process of assimilation seemed to emerge during treatment, in which the most relevant representations of significant others were projected onto the alliance with the therapist. @)15-1.*$# The alliance is considered an essential aspect of psychotherapy by many theorists and researchers (e.g., Muran & Barber, 2010). In the current study we delved into one of the possible origins of the alliance by examining the extent to which it could be explained by the atient’s representations of significant others. Our findings showed that representations of significant others, as examined before treatment begins, predicted a substantial part of the alliance with the real therapist: benevolent representations of others at intake were positively related to the alliance subsequently developed with the therapist, while malevolent representations of others were negatively related to the alliance subsequently developed with the therapist. The current findings constitute fertile ground for further examination of a variety of clinically important questions. While the current study focused on describing general phenomena, future research could examine the effect of individual differences between patients (such as patient’s interpersonal problems, Dinger, Zilcha-Mano, McCarthy, Barrett, & Barber, 2013, or attachment orientation) as well as the effects of specific characteristics of the real therapist (such as the therapist’s attachment orientation, or the therapist’s personal therapy experience, Gold & Hilsenroth, 2009), and the characteristics of the specific interactions between the patient and the therapist on the phenomena described in this study. Additionally, as the current study is not ideal for evaluating therapist effects, future large-scale studies with appropriate designs for investigating therapist’s effect (e.g., appropriate patients–therapist ratio and number of therapists, see Baldwin &
PTT
.01230/1.40/5&&'67894/0/571.8/5&&/6648./1.40&
Made with FlippingBook Ebook Creator