In Brief: Therapeutic alliance and treatment preference
Therapeutic alliance and treatment preference
In controlled clinical trials, patients are assigned to treatments at random, so some inevitably don't get the treatment they prefer. A new study shows that their disappointment can make it more difficult to establish a therapeutic alliance, the working relationship between patient and therapist that is probably the most important influence on the outcome of therapy.
In the four-month study, 75 depressed patients were assigned at random to psychotherapy, the antidepressant sertraline (Zoloft), or a placebo. Before the trial began, they were asked whether they preferred talk therapy or medication. The quality of the therapeutic alliance (as judged by the patient) and the severity of the patient's depressive symptoms were measured with standard questionnaires before, during, and after treatment.