Therapist verification of patient self-concepts as a responsive precondition for early alliance development and subsequent introject change

• Published in: Psychotherapy research pp. 1 - 15
• Main Authors: Constantino, Michael J, Coyne, Alice E, Gaines, Averi N, Goodwin, Brien J, Muir, Heather J, Critchfield, Kenneth L, Westra, Henny A, Antony, Martin M
• Format: Journal Article
• Language: English
• Published: England 30.12.2023
• Subjects: cognitive behavioral therapy; therapeutic alliance; self-verification; generalized anxiety disorder; self-concept/introject change; therapist responsiveness
• ISSN: 1050-3307; 1468-4381
• DOI: 10.1080/10503307.2023.2297995

Social psychological research has indicated that people strive for self-consistent feedback and interactions, even if negative, to preserve the epistemic security of knowing themselves. Without such , any interpersonal exchange may become frustrated, anxiety-riddled, and at risk for deterioration. Thus, it may be important for therapists to meet patients' self-verification needs as a responsive precondition for early alliance establishment and development. We tested this hypothesis with patients receiving cognitive behavioral therapy for generalized anxiety disorder-a condition that may render one's self-verification needs especially strong. We also tested the hypothesis that better early alliance quality would relate to subsequent adaptive changes in and posttreatment level of patients' self-concepts. Eighty-four patients rated their self-concepts at baseline and across treatment and follow-up, their postsession recollection of their therapist's interpersonal behavior toward them during session 2, and their experience of alliance quality rated after sessions 3-6. As predicted, the more therapists verified at session 2 a patient's baseline self-concepts (which trended toward disaffiliative and overcontrolling, on average), the more positively that patient perceived their next-session alliance. Moreover, better session 3 alliance related to more adaptive affiliative and autonomy-granting self-concepts at posttreatment. Results are discussed within a therapist responsiveness framework.