The role of the alliance in the association between interpersonal style and outcome

Tohar Dolev & Sigal Zilcha-Mano

Contemporary theories highlight the importance of the rupture resolution episodes on the process and outcome of treatment. Theoretically, it is expected that throughout the course of treatment some patients will be inclined to show more intense ruptures and that patients will also differ in the nature of their ruptures (withdrawal or confrontation). Furthermore, rupture resolution processes may be an important factor in predicting outcome. Yet little is known on the specific interpersonal problems that predict types and intensity of ruptures and on the moderation effect of rupture resolution processes on the association between the pretreatment interpersonal problems and outcome. In the current study sixty patients with a major diagnosis of major depressive disorder (MDD) receiving supportive expressive short term dynamic psychotherapy will participate. Participants complete the inventory of interpersonal problems (IIP) at intake, and were administered the semi structured Hamilton rating scale for depression (HRSD) at intake and before every session. All therapy sessions were videotaped and sessions 2,4 and 8 were coded using the rupture resolution rating system (3RS). The current study seeks to identify an association between interpersonal problems and the intensity and type of ruptures. We would also like to examine the potential moderation effect of rupture resolutions processes on the association between interpersonal problems and outcome. This study will shed light on the role of interpersonal problems on the formulating alliance and their effect on outcome.