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Behav Cogn Psychother. 2011 Mar;39(2):221-7. doi: 10.1017/S1352465810000792. Epub 2010 Nov 22.

Socialization to the model: the active component in the therapeutic alliance? A preliminary study.

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Department of Psychology, University of Bath, Claverton Down, Bath, UK.



Therapeutic alliance has been found to be a significant predictor of outcome in psychotherapy yet what constitutes therapeutic alliance remains unclear. Examining the common constructs of therapeutic alliance, it is possible that there may be a conceptual overlap between active components of therapeutic alliance and socialization to the treatment model.


To investigate the relationship between socialization to the model and therapeutic alliance.


Participants (N = 43) were taken from the active treatment arm in a RCT for the treatment of chronic fatigue syndrome (CFS/ME). Therapeutic alliance was measured using a 5-item questionnaire (brief CALPAS) and socialization to the model was extracted from therapy tapes using a novel coding system.


Key findings were that when patients and therapists agreed about goals of treatment, there were higher levels of concordance, less evidence of applying principles incongruent to the model, and less resistance during the treatment sessions.


The outcome of this preliminary study contributes to the potential understanding of active components in the therapeutic alliance, and supports further research to achieve a more detailed picture of "non-specific" factors in therapy, including the active process of socialization in therapeutic alliance.

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