title: Accuracy of therapist perceptions of patients' alliance: Exploring the divergence.
abstract: OBJECTIVE
  The therapeutic alliance is a well-established predictor of psychotherapy outcome, yet much research has shown that therapists' and patients' views of the alliance can diverge substantially. Therapists systematically underestimate their patients' perceived level of alliance, and the correlation between therapist and patient estimates of patient alliance is only moderate. The present study explored the divergence between therapists' and patients' perspectives on patients' alliance experience, and its relations to therapists' concurrent work involvement and session process experiences.
  
  
  METHODS
  Data from 98 patients treated by 26 therapists with psychodynamic psychotherapy were analyzed.
  
  
  RESULTS
  Therapist-patient divergence was significantly related to therapists' case-wise work involvement, but not to therapist's views of session process. The best predictor of therapist-patient divergence was therapists experiencing a "distressed practice" work involvement pattern.
  
  
  CONCLUSIONS
  Although therapists' work involvement experiences are not commonly investigated, they can be a relevant predictor of therapy processes.
authors.affiliation: a Department of Psychosomatic Medicine and Psychotherapy , Center for Mental Disorders, Medical Center - University of Freiburg , Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Hartmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Joos
authors.forename: David Elliot
authors.initials: DE
authors.lastname: Orlinsky
authors.forename: Almut
authors.initials: A
authors.lastname: Zeeck
mesh_terms: D000275:Adjustment Disorders / Q000628:therapy; D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D011369:Professional-Patient Relations; D013811:Psychotherapeutic Processes; D011613:Psychotherapy; D064889:Psychotherapy, Psychodynamic; D013001:Somatoform Disorders / Q000628:therapy
keywords: alliance; process research; psychoanalytic/psychodynamic therapy