ArticleJournal of consulting and clinical psychology2019
Working alliance predicts symptomatic improvement in public hospital-delivered psychotherapy in Nairobi, Kenya.
Article in Journal of consulting and clinical psychology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Methodological quality of network meta-analyses of Chinese herbal medicine could be improved: an evidence mapping.Naunyn-Schmiedeberg's archives of pharmacology · 2026Pooled it
- Differential effects of alliance and techniques on Panic-Specific Reflective Function and misinterpretation of bodily sensations in two treatments for panic.Psychotherapy research : journal of the Society for Psychotherapy Research · 2020Trial
- The bidirectional relationships between social isolation and cognitive function among older adults in China: separating between-person effects from within-person effects.Scientific reports · 2024Article
- Intake Characteristics as Predictors of Psychotherapy Outcome in a Practice Research Network in Argentina.Administration and policy in mental health · 2024Article
- The Importance of Conducting Practice-oriented Research with Underserved Populations.Administration and policy in mental health · 2024Article
- Article
- Client-therapist dyads and therapy outcome: Does sex matching matters? A cross-sectional study.BMC psychology · 2022Article
- Reevaluating the Alliance-Outcome Relationship in the Early Sessions of Cognitive Behavioral Therapy of Depression.Clinical psychological science : a journal of the Association for Psychological Science · 2021Article
- Towards a Person-Oriented Approach to Psychotherapy Research.Journal for person-oriented research · 2019Article
- Improving psychotherapies offered in public hospitals in Nairobi, Kenya: extending practice-based research model for LMICs.International journal of mental health systems · 2018Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveAlthough patient-therapist collaboration (working alliance) has been studied extensively in Europe and America, it is unknown to what extent the importance of working alliance for psychotherapy outcome generalizes to lower- and middle-income countries. Additionally, there is a need for more studies on the alliance using methods that are robust to confounders of its effect on outcome.
methodIn this study, 345 outpatients seeking care at the 2 public psychiatric hospitals in Nairobi, Kenya, filled out the Session Alliance Inventory (SAI) and the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) during each session. The effect of alliance on next-session psychological distress was modeled using the random intercept cross-lagged panel model, which estimates a cross-lagged panel model on within- and between-subjects disaggregated data.
resultsChanges in the working alliance from session to session significantly predicted change in psychological distress by the next session, with an increase of 1 point of the SAI in a given session resulting in a decrease of 1.27 points on the CORE-OM by the next session (SE = .60, 95% confidence interval [-2.44, -.10]). This finding represents a medium-sized standardized regression coefficient of between .16 and .21. Results were generally robust to sensitivity tests for stationarity, missing data assumptions, and measurement error.
conclusionResults affirm cross-cultural stability of the session-by-session reciprocal effects model of alliance and psychological distress-symptoms as seen in a Kenyan psychiatric outpatient sample, using the latest developments in cross-lagged panel modeling. A limitation of the study is its naturalistic design and lack of control over several variables. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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