Alliance and symptom improvement in inpatient treatment for eating disorder patients: A study of within-patient processes.

ABSTRACT

OBJECTIVE: This study examined the reciprocal relationship between alliance and symptoms during treatment for patients with eating disorders (ED). METHODS: Ninety one patients with EDs received inpatient cognitive-behavioral therapy treatment over 14 weeks. The study used repeated measurements during treatment and collected alliance and symptom measures. The analysis separated the effects of alliance and symptoms into between- and within-patient effects in a multilevel analysis. RESULTS: The results show a reciprocal relationship with between-patient alliance predicting ED symptoms and between-patient ED symptoms predicting alliance the subsequent weeks. However, for within-patient effects only alliance predicted ED symptoms the subsequent week. DISCUSSION: The results nuance the effect of the alliance in this patient group, and paint a complex picture of alliance in the psychotherapy process.