Early Alliance and Dropout

Open Access
- Author:
- Maramba, Gloria Juliana Kindt
- Graduate Program:
- Psychology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- August 19, 2004
- Committee Members:
- Louis Georges Castonguay, Committee Chair/Co-Chair
Thomas D Borkovec, Committee Member
Pamela Marie Cole, Committee Member
Dennis Edward Heitzmann, Committee Member - Keywords:
- alliance rupture
dropout
therapeutic alliance
rupture - Abstract:
- In this study, we attempted to identify interactions that characterize alliance ruptures in the early sessions. Neither disaffiliative interactions (i.e., traditional rupture markers) that distinguished good from poor outcome cases in previous studies, nor affiliative interactions that we proposed to uniquely characterize ruptures in the early sessions distinguished early dropouts from treatment continuers. Sheer verbosity during the session did not distinguish dropouts from continuer clients. Furthermore, aggregate measures of affiliation did not distinguish client-therapist dyads that terminated treatment from those that persisted with treatment beyond a few sessions. However, when a therapist engaged in any disaffiliative interaction, the client was more likely to discontinue with treatment than if the therapist did not. This was the case only when a more liberal definition of disaffiliation was employed, i.e., when ambiguously disaffiliative interactions were grouped with clearly disaffiliative interactions. Clinical and research implications are discussed.