The Therapeutic Alliance Predicts Outcomes of Cognitive Behavior Therapy but Not of Mindfulness-Based Cognitive Therapy for Depressive Symptoms

Meta-analyses have indicated a consistent correlation between the therapeutic alliance and treatment outcomes across various psychological treatments and patient populations, including treatments for depression. However, few studies have directly compared two active treatments with respect to the alliance-outcome association. A recent randomized trial demonstrated that the alliance was more strongly related to depressive symptom improvement in the cognitive behavioral analysis system of psychotherapy (which focuses more on enhancing collaborative working relationships) than in brief supportive psychotherapy for depression. This result suggests that the extent to which aspects of the therapeutic alliance (i.e. mutual agreement on therapeutic goals, mutual agreement on tasks, and the bond between the patient and therapist) are central to a treatment might affect the predictive value of the alliance.