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The aim of the study described in this paper was to develop a method for measuring the therapeutic alliance from an intersubjective perspective and to evaluate the efficacy of the measure in predicting psychotherapy outcome. We conducted the study using data from 22 patient-therapist dyads engaged in a 30-session protocol of a brief relational therapy. The alliance measure chosen for this purpose was the short form of the Working Alliance Inventory. We used the subjective patient and therapist versions of the measure and created a correlation index representing the intersubjective congruence between patients and therapists on their ratings of the alliance. We examined the relations among the measures, as well as their predictive relation to an outcome measure. The results showed significant intercorrelations among the three alliance measures, suggesting that all captured aspects of the therapeutic alliance. In addition, all three measures were significantly predictive of outcome, with the correlation index appearing more powerful. [ABSTRACT FROM AUTHOR]

This paper examines attachment theory in the context of the biology of affect regulation and the convergence of these in psychotherapeutic processes. Because of recent advances in understanding how the infant brain/mind/ body is shaped by the infant's first social experiences, the purpose of this investigation is to extract those underlying mechanisms that expand adaptive and regulatory capacities and to review their application within the therapeutic relationship. Interdisciplinary advances are indicating that just as the infant-mother relationship is fundamentally a psychobiological dyadic system of emotional communication and affect regulation, this same system underlies the essential mechanisms that adaptively sustain subsequent relationships--including the therapeutic alliance. This review highlights the importance of right-hemisphere-to-right-hemisphere emotional and relational processes--moving away from the traditional emphasis on "left-brain" verbal and cognitive processes--thereby underscoring the necessity for therapist understanding of implicit, nonverbal communication as well as self-integration and awareness in order to help increase their client's capacity for the same. We propose a model of therapeutic communication that takes these factors into account for the therapist, the client and the relationship. [ABSTRACT FROM AUTHOR]

In this paper, we consider the use of e-mail in psychotherapy and its impact on the experience of therapy for both patient and clinician. We discuss in detail the potential for boundary compromise by e-mail use and consider how e-mail may undermine the therapeutic alliance and the cultivation of empathy. Case studies illustrate the possible positive aspects of e-mail and elucidate several fundamental problems with any use of e-mail in psychodynamic treatment. [ABSTRACT FROM AUTHOR]