The therapeutic alliance: Its effect on other relationships

Published: March, 2006

Even psychotherapy that is helpful in other ways can interfere with the patient's social support system — the advice and comfort, encouragement and moral support of family, friends, and others. That suggestion comes from an article in the Harvard Review of Psychiatry. Its author, Harvard psychiatrist Richard Schwartz, says that it's a subject mental health professionals don't think about but should.

One reason they don't pay much attention to the issue is that psychiatric disorders themselves are often so damaging to human connections that it seems almost self-evident that any therapeutic effort can only improve them. In fact, there is good evidence that psychotherapy for major depression strengthens social connections — which is not surprising since isolation is a common result of depression. And couples therapy usually improves the couple's relationship, although less is known about its effect on their relationships with outsiders.

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