title: The associations among improvement and alliance expectations, alliance during treatment, and treatment outcome for major depressive disorder.
abstract: OBJECTIVE
  To examine the associations between treatment/outcome expectations, alliance before and during treatment, and the impact of alliance on symptomatic improvement.
  
  
  METHODS
  One hundred and fifty-three depressed patients randomized to dynamic supportive-expressive psychotherapy (SET), antidepressant medication (ADM) or placebo (PBO) + clinical management completed ratings of treatment expectations, therapeutic alliance (CALPAS, WAI-S), and depressive symptoms (HAM-D).
  
  
  RESULTS
  Pretreatment expectations of the therapeutic alliance were significantly related to alliance later in therapy but did not differ across treatments and did not predict outcome. Alliance development over time differed between treatments; it increased more in SET than in PBO. After controlling for prior symptom improvement, early alliance predicted subsequent depression change.
  
  
  CONCLUSIONS
  Expectations of alliance and of treatment outcome/improvement, measured prior to treatment onset, predicted subsequent alliance.
authors.affiliation: a Derner Institute , Adelphi University , Garden City , NY , USA.
authors.forename: Jacques P
authors.initials: JP
authors.lastname: Barber
authors.forename: Sigal
authors.initials: S
authors.lastname: Zilcha-Mano
authors.forename: Robert
authors.initials: R
authors.lastname: Gallop
authors.forename: Marna
authors.initials: M
authors.lastname: Barrett
authors.forename: Kevin S
authors.initials: KS
authors.lastname: McCarthy
authors.forename: Ulrike
authors.initials: U
authors.lastname: Dinger
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents