THE PROGNOSTIC RELEVANCE OF A WORKING ALLIANCE AS SEEN BY PATIENTS AND THERAPISTS

In general, the prognostic relevance of a working alliance for both th e course and the outcome of psychotherapy is no longer a matter of dis pute. Since a working alliance is conceived as an interactional variab le, the results must be interpreted on the basis of several important dimensions: the perspective of the investigator and the time structure during the course of therapy. Using the data available from the Berli n Psychotherapy Study (Rudolf 1991), we investigated for the 238 patie nts (inpatients and outpatients who received psychoanalytically orient ed therapy in the study) the prognostic relevance of diagnostic and th erapy-related working alliance variables for the various outcomes inve stigated. A complex correlation-statistical method (latent-trait-model ) was used to consider the investigator perspective with regard to the working alliance and the outcome as well as the time structure and th e diagnostic variables. Our results emphasize the relevance of the the rapist's perspective beginning with the diagnostic indication, the wor king alliance and finally the outcome. The patient's perspective,.howe ver, seems to be less relevant. The results are presented and disussed in relation to the relevant literature. One result we have found as a further important dimension is that the kind of therapy carried out m ust be taken into consideration. This implies that as in our study for all phases of the investigation therapy specific instruments must be applied. In this regard our results also contribute to the validation of the instrument used to measure the working alliance TAB.