Abstract
The authors examined whether alliance dynamics are affected by tailoring the therapeutic relationship to the individual patient in brief psychotherapy of borderline personality disorder. Sixty patients were randomized to 10-session Good Psychiatric Management (GPM-BV) or GPM combined with Motive-Oriented Therapeutic Relationship techniques (MOTR+GPM-BV). Patient-and therapist-rated alliance was assessed weekly. Self-reported symptomatic distress was assessed pre-, mid-, and posttreatment. In MOTR+GPM-BV, stronger therapist-rated alliance predicted lower symptomatic distress in the same timepoint, but not in a lag, whereas symptomatic distress predicted therapist-rated alliance in a lag. Therapist-rated alliance was lower than patient-rated alliance in GPM-BV but not in MOTR+GPM-BV. In MOTR+GPM-BV, higher agreement on strong alliance tended to predict lower symptomatic distress. Patient-and therapist-rated alliances were temporally congruent, but congruence did not predict outcome. Addressing the relationship needs of patients may partly exert its salutary effect by increasing agreement between patients’ and therapists’ experience of the alliance.
| Original language | English |
|---|---|
| Pages (from-to) | 1-21 |
| Number of pages | 21 |
| Journal | Journal of Personality Disorders |
| Volume | 34 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2020 |
| Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2020 The Guilford Press.
Funding
Preparation of this article was supported by a grant from the Swiss National Science Foundation (Grant No. 100014-134562; PI: Ueli Kramer) and by grants from the Fulbright program (PI: Yogev Kivity), the American Psychoanalytic Association (PI: Yogev Kivity), the International Psychoanalytic Association (PI: Yogev Kivity, co-PI: Kenneth N. Levy), and the American Psychological Association, Division 29 (PI: Yogev Kivity, co-PI: Kenneth N. Levy). From Department of Psychology, Pennsylvania State University, University Park, Pennsylvania (Y. K., K. N. L.); General Psychiatry Service, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland (S. K.); and General Psychiatry Service and Institute of Psychotherapy, Department of Psychiatry, CHUV, University of Lausanne, Lausanne, Switzerland (U. K.). Preparation of this article was supported by a grant from the Swiss National Science Foundation (Grant No. 100014-134562; PI: Ueli Kramer) and by grants from the Fulbright program (PI: Yogev Kivity), the American Psychoanalytic Association (PI: Yogev Kivity), the International Psychoanalytic Association (PI: Yogev Kivity, co-PI: Kenneth N. Levy), and the American Psychological Association, Division 29 (PI: Yogev Kivity, co-PI: Kenneth N. Levy). Conflict of Interest Statement: None declared. Address correspondence to Dr. Yogev Kivity, Department of Psychology, Pennsylvania State University, 355 Bruce V. Moore Building, University Park, PA 16802. E-mail: [email protected]
| Funders | Funder number |
|---|---|
| Fulbright Program | |
| American Psychoanalytic Association | |
| American Psychological Association | |
| International Association for Psychoanalytic Self Psychology | |
| International Psychoanalytical Association | |
| Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung | 100014-134562 |
Keywords
- Borderline personality disorder
- Good psychiatric management
- Motive oriented therapeutic relationship
- Plan analysis
- Therapeutic alliance
