title: Predictors of therapeutic alliance in two treatments for adults with severe and enduring anorexia nervosa.
abstract: BACKGROUND
  Therapeutic alliance (TA) has been found to be a significant predictor of outcome for patients with severe and enduring anorexia nervosa (SE-AN), accounting for more variance than treatment type. To better understand how to promote TA for this population, the aim of the current study was to investigate predictors of TA in adults with SE-AN.
  
  
  METHODS
  Participants were 63 adult females with SE-AN presenting to an outpatient, multi-site randomized controlled trial conducted at two clinical sites. Participants' perception of the quality of their therapeutic relationship, demographic information, and eating disorder symptomatology were assessed via interview and questionnaire measures.
  
  
  RESULTS
  Baseline ratings of how successful participants believed treatment would be for them was the only variable to significantly predict early (p = .01), mid (p = .009), and late treatment alliance (p = .03). No other variables investigated predicted the quality of patient rated TA at any point in treatment (ps > .57).
  
  
  CONCLUSIONS
  Results suggest instilling hope in treatment outcome may enhance TA, and in turn, outcomes for patients with SE-AN in outpatient therapy.
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Stiles-Shields
authors.affiliation: The London Centre for Eating Disorders and Body Image, London, UK.
authors.forename: Bryony H
authors.initials: BH
authors.lastname: Bamford
authors.affiliation: University of Sydney, School of Psychology, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Touyz
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, CA USA ; Department of Pediatrics, University of California, San Francisco, San Francisco, CA USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Grange
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Hay
authors.affiliation: St. George's, University of London, Eating Disorders Research Group, London, UK.
authors.forename: Hubert
authors.initials: H
authors.lastname: Lacey
keywords: Anorexia nervosa; Cognitive behavioral therapy; Predictors; Specialist supportive clinical management; Therapeutic alliance