How does the therapeutic alliance develop throughout cognitive behavioral therapy for panic disorder? Sawtooth patterns, sudden gains, and stabilization

Michal Weiss, Yogev Kivity, Jonathan D. Huppert

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Objective: There has been little research on the development of the therapeutic alliance in cognitive behavioral therapy (CBT). This study aims to examine the development of therapeutic alliance in CBT for panic disorder. Method: Nineteen patients were treated with CBT for panic disorder. Pre- and post-session data of the therapeutic alliance and panic symptoms and cognitions were collected. Results: Several patterns were observed, including a sawtooth pattern (within-session improvements followed by decline between sessions; 63% of the patients), sudden gains in the alliance (58%), and late stabilization (89%). The sawtooth pattern was related to less symptom reduction between sessions (explained variance = 20-48%). Though not statistically significant, there were moderate effect sizes for the relationships between outcomes and early alliance and sudden gains (explained variance = 13-17%). Conclusions: Overall, results suggest that intensive data collection is likely to yield understanding of the relationship between therapy processes and outcomes.

Original languageEnglish (US)
Pages (from-to)407-418
Number of pages12
JournalPsychotherapy Research
Volume24
Issue number3
DOIs
StatePublished - May 2014

All Science Journal Classification (ASJC) codes

  • Clinical Psychology

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