title: Relationship Between Patient SWAP-200 Personality Characteristics and Therapist-Rated Therapeutic Alliance Early in Treatment.
abstract: In the present study, we assess the extent to which patient personality features and prototypes are associated with early treatment therapist-rated alliance. The study sample consisted of 94 patients receiving psychodynamic psychotherapy at an outpatient clinic. Clinicians completed the Working Alliance Inventory (J Couns Psychol 36:223-233; Psychother Res 9:405-423) to assess their views of early alliance and the Shedler-Westen Assessment Procedure 200 (SWAP-200; Assessment 5:333-353, Am J Psychiatry 161:1350-1365, 1743-1754; Am J Psychiatry 156:258-272, 273-285) to assess patient personality. The SWAP-200 Narcissistic Clinical Prototype, Dysphoric Q-Factor, and Dysphoric/High-Functioning Neurotic Q-Subfactor significantly correlated with early therapist-rated alliance. Correlations that trended toward significance were also found. Also identified were specific SWAP-200 items that were found to relate to high early therapist-rated alliance scores. These results demonstrate some relationship, albeit small, between patient personality characteristics and therapists' views of the alliance that may serve to further a conceptual understanding of the alliance, specific personality syndromes, and the associated impact on the therapeutic interaction.
authors.affiliation: *York College, City University of New York, Jamaica; and †Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, NY.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Smith
authors.forename: Saryn R
authors.initials: SR
authors.lastname: Levy
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Hilsenroth
authors.forename: Katherine
authors.initials: K
authors.lastname: Fiori
authors.forename: Robert F
authors.initials: RF
authors.lastname: Bornstein
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000592:standards; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory / Q000592:standards; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods; D064889:Psychotherapy, Psychodynamic / Q000379:methods* / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult