The effect of congruence in patient and therapist alliance on patient's symptomatic levels

Objective: The ability of alliance to predict outcome has been widely demonstrated, but less is known about the effect of the level of congruence between patient and therapist alliance ratings on outcome. In the current study we examined whether the degree of congruence between patient and therapist alliance ratings can predict symptomatic levels 1 month later in treatment. Method: The sample consisted of 127 patient–therapist dyads. Patients and therapists reported on their alliance levels, and patients reported their symptomatic levels 1 month later. Polynomial regression and response surface analysis were used to examine congruence. Results: Findings suggest that when the congruence level of patient and therapist alliance ratings was not taken into account, only the therapist's alliance served as a significant predictor of symptomatic levels. But when the degree of congruence between patient and therapist alliance ratings was considered, the degree of congruence was a significant predictor of symptomatic levels 1 month later in treatment. Conclusions: Findings support the importance of the level of congruence between patient and therapist alliance ratings in predicting patient's symptomatic levels.