The Historical Evolution and Modern Research of the Alliance in Psychotherapy and Counseling

123

Abstract

This article presents a narrative review of the development of the concept of the “alliance” in psychotherapy and counseling and its current research trends. The paper describes the change in the perceptions of the alliance — from its perception as neurotic transfer to a separate parameter of relationship, consisting of successful collaboration and trusting interpersonal connection. The most commonly used survey methods for assessing the alliance are reviewed, with psychometric properties provided. The article gives an overview of the use of psycho-physiological and behavioral parameters of the therapist and client as correlates of the alliance. The advantages and disadvantages of objective methods of studying the alliance are discussed. The authors note the relationship between the quality of the alliance in the therapist-client dyads and the degree of interpersonal synchronization of the dyads at different levels during sessions, including measures of oxytocin, the convergence of dyad language styles, and the level of brain-to-brain synchronization. The authors conclude that conducting multi-level, interdisciplinary studies that combine objective and subjective parameters is necessary for the formation of a model of the alliance that includes its cognitive and affective aspects.

General Information

Keywords: psychotherapy, counseling, therapeutic relationship, alliance, evolution of alliance, common factors

Journal rubric: Theoretical Research

Article type: scientific article

DOI: https://doi.org/10.17759/cpse.2023120302

Funding. This research was supported by the Ministry of Science and Higher Education of the Russian Federation, (Agreement № 075-10-2021-093, Project COG-RND-2104).

Received: 15.08.2023

Accepted:

For citation: Oreshina G.V., Zhukova M.A. The Historical Evolution and Modern Research of the Alliance in Psychotherapy and Counseling [Elektronnyi resurs]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2023. Vol. 12, no. 3, pp. 30–56. DOI: 10.17759/cpse.2023120302. (In Russ., аbstr. in Engl.)

References

  1. Krasilshchikova E.A. Oprosnik pomogayushchikh otnoshenii [Questionnaire of helping relationships]. Sait psikhologov B17.ru. URL: https://www.b17.ru/tests/therapeutic_alliance/ (Accessed: 06.10.2023). (In Russ.).
  2. Pugovkina O.D., Kholmogorova A.B. Terapevticheskii al'yans v psikhoterapii [Therapeutic alliance in psychotherapy]. Sovremennaya terapiya psikhicheskikh rasstroistv = Modern Therapy of Mental Disorders, 2011, no. 3, pp. 14–21. (In Russ.).
  3. Aafjes-van Doorn K., Porcerelli J., Müller-Frommeyer L.C. Language style matching in psychotherapy: An implicit aspect of alliance. Journal of Counseling Psychology, 2020. Vol. 67 (4), pp. 509–522. DOI: 10.1037/cou0000433
  4. Alldredge C., Burlingame G.M., Yang C. et al. Alliance in group therapy: A meta-analysis. Group Dynamics: Theory, Research, and Practice, 2021. Vol. 25 (1), pp. 13–28. DOI: 10.1037/gdn0000135
  5. Altmann U., Schoenherr D., Paulick J. et al. Associations between movement synchrony and outcome in patients with social anxiety disorder: Evidence for treatment specific effects. Psychotherapy Research, 2020. Vol. 30 (5), pp. 574–590. DOI: 10.1080/10503307.2019.1630779
  6. Andrade-González N., Fernández-Liria A. Spanish adaptation of the Revised Helping Alliance Questionnaire (HAq-II). Journal of Mental Health (Abingdon, England), 2015. Vol. 24, no. 3, pp. 155–161. DOI: 10.3109/09638237.2015.1036975
  7. Ardito R.B., Rabellino D. Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2011. Vol. 2, article 270. DOI: 10.3389/fpsyg.2011.00270
  8. Baier A.L., Kline A.C., Feeny N.C. Therapeutic alliance as a mediator of change: A systematic review and evaluation of research. Clinical Psychology Review, 2020. Vol. 82, article 101921. DOI: 10.1016/j.cpr.2020.101921
  9. BarcellosSerralta F., Pereira da Cruz Benetti S., Braga Laskoski P. et al. The Brazilian-adapted Working Alliance Inventory: Preliminary report on the psychometric properties of the original and short revised versions. Trends in Psychiatry and Psychotherapy, 2020. Vol. 42, no. 3, pp. 256–261. DOI: 10.1590/2237-6089-2019-0099
  10. Bar-Kalifa E., Prinz J.N., Atzil-Slonim D. et al. Physiological synchrony and therapeutic alliance in an imagery-based treatment. Journal of Counseling Psychology, 2019. Vol. 66, no. 4, pp. 508–517. DOI: 10.1037/cou0000358
  11. Bassler M., Nübling R. Helping Alliance Questionnaire. In K. Geue, B. Strauß, E. Brähler (eds.), DiagnostischeVerfahren in der Psychotherapie. Göttingen: HogrefeVerlag, 2015. Pp. 246–249.
  12. Bibring E. Symposium on the theory of the therapeutic results of psycho-analysis. 1937. Journal of Mental Science, 2018. Vol. 83, no. 346, pp. 585–586. DOI: 10.1192/bjp.83.346.585-b
  13. Bordin E.S. The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 1979. Vol. 16, pp. 252–260. DOI: 10.1037/H0085885
  14. Bourke E., Barker C., Fornells-Ambrojo M. Systematic review and meta-analysis of therapeutic alliance, engagement, and outcome in psychological therapies for psychosis. Psychology and Psychotherapy, 2021. Vol. 94, no. 3, pp. 822–853. DOI: 10.1111/papt.12330
  15. Buchholz J.L., Abramowitz J.S. The therapeutic alliance in exposure therapy for anxiety-related disorders: A critical review. Journal of Anxiety Disorders, 2020. Vol. 70, article 102194. DOI: 10.1016/j.janxdis.2020.102194
  16. Burns J.W., Nielson W.R., Jensen M.P. et al. Specific and general therapeutic mechanisms in cognitive behavioral treatment of chronic pain. Journal of Consulting and Clinical Psychology, 2015. Vol. 83, pp. 1–11. DOI: 10.1037/a0037208
  17. Cameron S.K., Rodgers J., Dagnan D. The relationship between the therapeutic alliance and clinical outcomes in cognitive behaviour therapy for adults with depression: A meta-analytic review. Clinical Psychology & Psychotherapy, 2018. Vol. 25, no. 3, pp. 446–456. DOI: 10.1002/cpp.2180
  18. Cirasola A., Midgley N., Fonagy P. et al. The factor structure of the Working Alliance Inventory short-form in youth psychotherapy: An empirical investigation. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 2021. Vol. 31, no. 4, pp. 535–547. DOI: 10.1080/10503307.2020.1765041
  19. Clements-Hickman A.L., Reese R.J. The person of the therapist: therapists’ personal characteristics as predictors of alliance and treatment outcomes, Psychotherapy Research, 2023. Vol. 33, no. 2, pp. 173–184. DOI:10.1080/10503307.2022.2080610
  20. Cohen K., Ramseyer F.T., Tal S. et al. Nonverbal synchrony and the alliance in psychotherapy for major depression: Disentangling state-like and trait-like effects. Clinical Psychological Science, 2021. Vol. 9, no. 4, pp. 634–648. DOI: 10.1177/2167702620985294
  21. Cuijpers P., Reijnders M., Huibers M.J.H. The role of common factors in psychotherapy outcomes. Annual Review of Clinical Psychology, 2019. Vol. 15, pp. 207–231. DOI: 10.1146/annurev-clinpsy-050718-095424
  22. Dattilio F.M., Hanna M.A. Collaboration in cognitive-behavioral therapy. Journal of Clinical Psychology, 2012. Vol. 68, no. 2, pp. 146–158. DOI: 10.1002/jclp.21831
  23. Del Giacco L.D., Anguera M.T., Salcuni S. The action of verbal and non-verbal communication in the therapeutic alliance construction: A mixed methods approach to assess the initial interactions with depressed patients. Frontiers in Psychology, 2020. Vol. 11, article 234. DOI: 10.3389/fpsyg.2020.00234
  24. Eich H.S., Kriston L., Schramm E. et al. The German version of the helping alliance questionnaire: psychometric properties in patients with persistent depressive disorder. BMC Psychiatry, 2018. Vol. 18, no. 1, article 107.
  25. Elvins R., Green J. The conceptualization and measurement of therapeutic alliance: an empirical review. Clinical Psychology Review, 2008. Vol. 28, no. 7, pp. 1167–1187. DOI: 10.1016/j.cpr.2008.04.002
  26. Erby L.H., Wisniewski T., Lewis K.L. et al. Adaptation of the working alliance inventory for the assessment of the therapeutic alliance in genetic counseling. Journal of Genetic Counseling, 2021. Vol. 30, no. 1, pp. 11–21. DOI: 10.1002/jgc4.1378
  27. Eubanks C.F., Muran J.C., Safran J.D. Repairing alliance ruptures. New York, NY: Oxford University Press, 2019, pp. 549–579.
  28. FaceReader. Noldus Information Technology BV. URL: https://www.noldus.com/facereader (Accessed: 06.10.2023).
  29. Feeley M., DeRubeis R.J., Gelfand L.A. The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 1999. Vol. 67, no. 4, pp. 578–582. DOI: 10.1037//0022-006x.67.4.578
  30. Flückiger C., Del Re A.C., Wampold B.E. et al. The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 2018, no. 55 (4), pp. 316–340. DOI: 10.1037/pst0000172
  31. Freud Z. The dynamics of transference. In J. Strachey, A. Freud, A. Strachey, A. Tyson (eds.), The Standard Edition of the Complete Psychological Works of Sigmund Freud. Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, 1958, pp. 97–109.
  32. Friedlander M.L., Escudero V., Welmers-van de Poll M.J. et al. Meta-analysis of the alliance-outcome relation in couple and family therapy. Psychotherapy (Chicago, Ill.), 2018. Vol. 55, no. 4, pp. 356–371. DOI: 10.1037/pst0000161
  33. Gaston L. The concept of the alliance and its role in psychotherapy: Theoretical and empirical considerations. Psychotherapy: Theory, Research, Practice, Training, 1990. Vol. 27, pp. 143–153. DOI: 10.1037/0033-3204.27.2.143
  34. Goldberg S.B., Baldwin S.A., Riordan K.M. Alliance with an unguided smartphone app: Validation of the digital working alliance inventory. Assessment, 2022. Vol. 29, no. 6, pp. 1331–1345. DOI: 10.1177/10731911211015310
  35. Goldberg S.B., Flemotomos N., Martinez V.R. et al. Machine learning and natural language processing in psychotherapy research: Alliance as example use case. Journal of Counseling Psychology, 2020. Vol. 67, no. 4, pp. 438–448. DOI: 10.1037/cou0000382
  36. Greenberg L.S., Pinsof W.M. The psychotherapeutic process: A research handbook. NewYork: GuilfordPress, 1986. 741 p.
  37. Greenson R.R. The working alliance and the transference neurosis. 1965. The Psychoanalytic Quarterly, 2008. Vol. 77, pp. 77–102.
  38. Hatcher R.L., Lindqvist K., Falkenström F. Psychometric evaluation of the Working Alliance Inventory-Therapist version: Current and new short forms. Psychotherapy Research, 2020. Vol. 30, no. 6, pp. 706–717. DOI: 10.1080/10503307.2019.1677964
  39. Heppner P.P., Claiborn C.D. Social influence research in counseling: A review and critique. Journal of Counseling Psychology, 1989. Vol. 36, no. 3, pp. 365–387. DOI: 10.1037/0022-0167.36.3.365
  40. Herrero R., Vara M.D., Miragall M. Working alliance inventory for online interventions-short form (WAI-TECH-SF): The Role of the therapeutic alliance between patient and online program in therapeutic outcomes. International Journal of Environmental Research and Public Health, 2020. Vol. 17, no. 17, article 6169. DOI: 10.3390/ijerph17176169
  41. Horvath A.O. The therapeutic relationship: from transference to alliance. Journal of Clinical Psychology, 2000. Vol. 56, no. 2, pp. 163–173. DOI: 10.1002/(sici)1097-4679(200002)56:2<163::aid-jclp3>3.0.co;2-d
  42. Horvath A.O., Greenberg L.S.Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 1989. Vol. 36, no. 2, pp. 223–233.
  43. Horvath A. O., Luborsky L. The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology, 1993. vol. 61, no. 4, pp. 561–573.
  44. Hougaard E. The therapeutic alliance: A conceptual analysis. Scandinavian Journal of Psychology, 1994. Vol. 35, no. 1, pp. 67–85. DOI: 10.1111/j.1467-9450.1994.tb00934.x
  45. Huang Y., Huang X., Ebstein R.P. et al. Intranasal oxytocin in the treatment of autism spectrum disorders: A multilevel meta-analysis. Neuroscience & Biobehavioral Reviews, 2021. Vol. 122, pp. 18–27. DOI: 10.1016/j.neubiorev.2020.12.028
  46. Hunik L., Galvin S., Olde Hartman T. et al. Exploring the psychometric properties of the Working Alliance Inventory in general practice: A cross-sectional study. BJGP Open, 2021. Vol. 5, no. 1, article bjgpopen20X101131. DOI: 10.3399/bjgpopen20X101131
  47. Jung E., Wiesjahn M., Rief W. et al. Perceived therapist genuineness predicts therapeutic alliance in cognitive behavioural therapy for psychosis. British Journal of Clinical Psychology, 2015. Vol. 54, no. 1, pp. 34–48. DOI: 10.1111/bjc.12059
  48. Kim S.C., Boren D., Solem S.L. The Kim Alliance Scale: development and preliminary testing. Clinical Nursing Research, 2001. Vol. 10, no. 3, pp. 314–331. DOI: 10.1177/c10n3r7
  49. Kivlighan M., Cohen K., Zilcha-Mano S. et al. Examining state and trait alliance in group therapy: A within-person and between-person actor–partner interdependence model. Group Dynamics: Theory, Research, and Practice, 2022. Vol. 26, pp. 137–150. DOI: 10.1037/gdn0000152
  50. Koole S.L., Tschacher W. Synchrony in psychotherapy: A review and an integrative framework for the therapeutic alliance. Frontiers in Psychology, 2016. Vol. 7, article 862. DOI: 10.3389/fpsyg.2016.00862
  51. Kupper Z., Ramseyer F., Hoffmann H. et al. Video-based quantification of body movement during social interaction indicates the severity of negative symptoms in patients with schizophrenia. Schizophrenia Research, 2010. Vol. 121, no. 1–3, pp. 90–100. DOI: 10.1016/j.schres.2010.03.032
  52. Lord S.P., Sheng E., Imel Z.E. et al. More than reflections: Empathy in motivational interviewing includes language style synchrony between therapist and client. Behavior Therapy, 2014. Vol. 46, no. 3, pp. 296–303. DOI: 10.1016/j.beth.2014.11.002
  53. Luborsky L. Helping alliance in psychotherapy. In J.L. Cleghhorn (ed.), Successful Psychotherapy. New York: Brunner/Mazel, 1976. Pp. 92–116.
  54. Luborsky L., Barber J.P., Siqueland L. et al. The revised helping alliance questionnaire (HAq-II): Psychometric properties. The Journal of Psychotherapy Practice and Research, 1996. Vol. 5 (3), pp. 260–71.
  55. Luborsky L., Crits-Christoph P., Alexander L. et al. Two helping alliance methods for predicting outcomes of psychotherapy. A counting signs vs. a global rating method. The Journal of Nervous and Mental Disease, 1983. Vol. 171, no 8, pp. 480–491. DOI: 10.1097/00005053-198308000-00005
  56. McLaughlin A.A., Keller M.S., Feeny N.C. et al. Patterns of therapeutic alliance: Rupture–repair episodes in prolonged exposure for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 2014. Vol. 82, no. 1, pp. 112–121. DOI: 10.1037/a0034696
  57. MEA. URL: https://psync.ch/WordPress (Accessed: 10.07.2023)
  58. Mulder R., Murray G., Rucklidge J. Common versus specific factors in psychotherapy: Opening the black box. The Lancet Psychiatry, 2017. Vol. 4, no. 12, pp. 953–962. DOI: 10.1016/S2215-0366(17)30100-1
  59. Nawijn L., van Zuiden M., Koch S.B.J. et al. Intranasal oxytocin increases neural responses to social reward in post-traumatic stress disorder. Social Cognitive and Affective Neuroscience, 2017. Vol. 12, no. 2, pp. 212–223. DOI: 10.1093/scan/nsw123
  60. Nübling R., Kraft M., Henn J. et al. Testing the psychometric properties of the Helping Alliance Questionnaire (HAQ) in different health scare settings. Psychotherapie, Psychosomatik, MedizinischePsychologie, 2017. Vol. 67, no. 11, pp. 465–476. DOI: 10.1055/s-0043-111083
  61. OpenPose 1.7.0. URL: https://cmu-perceptual-computing-lab.github.io/openpose/web/html/doc/index.html (Accessed: 06.10.2023).
  62. Paap D., Karel Y.H.J.M., Verhagen A.P. et al. The working alliance inventory’s measurement properties: A systematic review. Frontiers in Psychology, 2022. Vol. 13, article 945294. DOI: 10.3389/fpsyg.2022.945294
  63. Paap D., Schepers M., Dijkstra P.U. Reducing ceiling effects in the Working Alliance Inventory-Rehabilitation Dutch Version. Disability and Rehabilitation, 2020. Vol. 42, no. 20, pp. 2944–2950. DOI: 10.1080/09638288.2018.1563833
  64. Paulick J., Deisenhofer A.-K., Ramseyer F.T. et al. Nonverbal synchrony: A new approach to better understand psychotherapeutic processes and drop-out. Journal of Psychotherapy Integration, 2018. Vol. 28, no. 3, pp. 367–384. DOI: 10.1037/int0000099
  65. Paulick J., Rubel J.A., Deisenhofer A.-K. et al. Diagnostic features of nonverbal synchrony in psychotherapy: Comparing depression and anxiety. Cognitive Therapy and Research, 2018. Vol. 42, pp. 539–551. DOI: 10.1007/s10608-018-9914-9
  66. Prinz J., Boyle K., Ramseyer F. et al. Within and between associations of nonverbal synchrony in relation to Grawe’s general mechanisms of change. Clinical Psychology & Psychotherapy, 2021. Vol. 28, no. 1, pp. 159–168. DOI: 10.1002/cpp.2498
  67. Ramseyer F.T. Motion energy analysis (MEA): A primer on the assessment of motion from video. Journal of Counseling Psychology, 2020. Vol. 67, pp. 536–549. DOI: 10.1037/cou0000407
  68. Ramseyer F., Tschacher W. Nonverbal synchrony in psychotherapy: coordinated body movement reflects relationship quality and outcome. Journal of Consulting and Clinical Psychology, 2011. Vol. 79, no. 3, pp. 284–295. DOI: 10.1037/a0023419
  69. Ramseyer F., Tschacher W. Synchrony: A core concept for a constructivist approach to psychotherapy. Constructivism in the Human Sciences, 2006. Vol. 11, no. 1–2, pp. 150–171.
  70. Ramseyer F., Tschacher W. Synchrony in dyadic psychotherapy sessions. In S. Vrobel, O.E. Rössler, T. Marks-Tarlow (eds.) Simultaneity: Temporal Structures and Observer Perspectives. Singapore: World Scientific Publishing, 2008. Pp. 329–347. DOI: 10.1142/9789812792426_0020
  71. Rector N.A., Zuroff D.C., Segal Z.V. Cognitive change and the therapeutic alliance: The role of technical and nontechnical factors in cognitive therapy. Psychotherapy: Theory, Research, Practice, Training, 1999. Vol. 36, no. 4, pp. 320–328. DOI: 10.1037/h0087739
  72. Ribeiro N.S., Colugnati F.A.B., Kazantzis N. et al. Observing the working alliance in videoconferencing psychotherapy for alcohol addiction: Reliability and validity of the working alliance inventory short revised observer. Frontiers in Psychology, 2021. Vol. 12, article 647814. DOI: 10.3389/fpsyg.2021.647814
  73. Rogers C.R. Dealing with interpersonal conflict. Pastoral Psychology, 1952. Vol. 3, pp. 14–20.
  74. Rogers C.R. My philosophy of interpersonal relationships and how it grew. Journal of Humanistic Psychology, 1973. Vol. 13, no. 2, pp. 3–15. DOI: 10.1177/002216787301300202
  75. Rogers C.R. The attitude and orientation of the counselor in client-centered therapy. Journal of Consulting Psychology, 1949. Vol. 13, no. 2, pp. 82–94. DOI: 10.1037/h0059730
  76. Rogers C.R. The characteristics of a helping relationship. The Personnel and Guidance Journal, 1958. Vol. 37, no. 1, pp. 6–16. DOI: 10.1002/J.2164-4918.1958.TB01147.X
  77. Rogers C.R. The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 1957. Vol. 21, no. 2, pp. 95–103.
  78. Salazar Kämpf M., Nestler S., Hansmeier J. et al. Mimicry in psychotherapy – an actor partner model of therapists’ and patients’ non-verbal behavior and its effects on the working alliance. Psychotherapy Research, 2021. Vol. 31, no. 6, pp. 752–764. DOI: 10.1080/10503307.2020.1849849
  79. Scholl C.C., CarretSoares M., do Nascimento E. et al. Evidence of validity of the revised Helping Alliance Questionnaire based on the internal structure in a Brazilian clinical sample. Clinical Psychology & Psychotherapy, 2022. Vol. 29, no. 2, pp. 622–630. DOI: 10.1002/cpp.2654
  80. Shapiro D.A., Shapiro D. Meta-analysis of comparative therapy outcome studies: A replication and refinement. Psychological Bulletin, 1982. Vol. 92, no. 3, pp. 581–604.
  81. Shirk S. R., Karver M. S., Brown R. The alliance in child and adolescent psychotherapy. Psychotherapy (Chic), 2011. Vol. 48, no. 1, pp. 17–24. DOI: 10.1037/a0022181
  82. Smith M.L., Glass G.V. Meta-analysis of psychotherapy outcome studies. American Psychologist, 1977. Vol. 32, no. 9, pp. 752–760. DOI: 10.1037//0003-066x.32.9.752
  83. Stefens M., Rondeel E., Templin J. et al. Longitudinal measurement invariance of the Working Alliance Inventory - Short form across coaching sessions. BMC Psychology, 2022. Vol. 10, no. 1, article 277. DOI: 10.1186/s40359-022-00968-5
  84. Sterba R. The fate of the ego in analytic therapy. The International Journal of Psychoanalysis, 1934. Vol. 15, pp. 117–126.
  85. Strong S.R. Counseling: An interpersonal influence process. Journal of Counseling Psychology, 1968. Vol. 15, no. 3, pp. 215–224. DOI: 10.1037/h0020229
  86. Sturgiss E.A., Rieger E., Haesler E. et al. Adaption and validation of the Working Alliance Inventory for General Practice: qualitative review and cross-sectional surveys. Family Practice, 2019. Vol. 36, no. 4, pp. 516–522. DOI: 10.1093/fampra/cmy113
  87. Takasaki H., Miki T., Hall T. Development of the Working Alliance Inventory-Short Form Japanese version through factor analysis and test-retest reliability. Physiotherapy Theory and Practice, 2020. Vol. 36, no. 3, pp. 444–449. DOI: 10.1080/09593985.2018.1487492
  88. Whiston S., Rossier J., Baron P. The working alliance in career counseling: A systematic overview. Journal of Career Assessment, 2016. Vol. 24, pp. 591–604. DOI: 10.1177/1069072715615849
  89. Zetzel E.R. Current concepts of transference. The International Journal of Psycho-Analysis, 1956. Vol. 37, no, 4–5, pp. 369–376.
  90. Zhang Y. Meng T., Yang Y. et al. Experience-dependent counselor-client brain synchronization during psychological counseling. eNeuro, 2020. Vol. 7, no. 5. DOI: 10.1523/ENEURO.0236-20.2020
  91. Zhang Y., Meng T., Hou Y. et al. Interpersonal brain synchronization associated with working alliance during psychological counseling. Psychiatry Research. Neuroimaging, 2018. Vol. 282, pp. 103–109. DOI: 10.1016/j.pscychresns.2018.09.007
  92. Zilcha-Mano S., Fisher H. Distinct roles of state-like and trait-like patient–therapist alliance in psychotherapy. Nature Reviews Psychology, 2022. Vol. 1, no. 4, pp. 194–210. DOI: 10.1038/s44159-022-00029-z
  93. Zilcha-Mano S., Goldstein P., Dolev-Amit T. et al. Oxytocin synchrony between patients and therapists as a mechanism underlying effective psychotherapy for depression. Journal of Consulting and Clinical Psychology, 2021. Vol. 89, pp. 49–57. DOI: 10.1037/ccp0000619
  94. Zilcha-Mano S., Shamay-Tsoory S., Dolev-Amit T. et al. Oxytocin as a biomarker of the formation of therapeutic alliance in psychotherapy and counseling psychology. Journal of Counseling Psychology, 2020. Vol. 67, pp. 523–535. DOI: 10.1037/cou0000386
  95. Zilcha-Mano S., Webb C.A. Disentangling trait-like between-individual vs. state-like within-individual effects in studying the mechanisms of change in CBT. Frontiers in Psychiatry, 2021. Vol. 11, article 609585. DOI: 10.3389/fpsyt.2020.609585

Information About the Authors

Galina V. Oreshina, Research Assistant, Center for Cognitive Sciences, Sirius University of Science and Technology, Russia, ORCID: https://orcid.org/0000-0002-5955-6471, e-mail: oreshina.gv@talatiuspeh.ru

Marina A. Zhukova, PhD in Psychology, Postdoctoral Fellow, Boston Children’s Hospital, Harvard Medical School, Boston, USA, ORCID: https://orcid.org/0000-0002-3069-570X, e-mail: zhukova.ma@talantiuspeh.ru

Metrics

Views

Total: 502
Previous month: 97
Current month: 63

Downloads

Total: 123
Previous month: 20
Current month: 7