Linguistic features of the therapeutic alliance in the first session: a psychotherapy process study

  • Attà Negri | atta.negri@unibg.it Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
  • Christopher Christian City College of New York, New York, NY, United States.
  • Rachele Mariani Italian Psychoanalytic Society, Rome, Italy.
  • Luca Belotti Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
  • Giovanbattista Andreoli Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy.
  • Kerri Danskin Princeton University, Princeton, NJ, United States.

Abstract

Critical aspects of the therapeutic alliance appear to be established as early as the first session. Specifically, the affective bond between the therapeutic dyad appears to develop early in treatment and tends to remain stable over time, while agreements on goals and tasks tend to fluctuate over the course of treatment. Are there distinguishable early signs of a strong therapeutic alliance? In this study, we examined how some linguistic measures indicative of joint emotional elaboration correlated with a measure of the therapeutic alliance assessed within a single session. Initial intake sessions with 40 patients with varying diagnoses were videotaped, transcribed, and analyzed using linguistic measures of referential process and then scored with the Segmented Working Alliance Inventory-Observer form. Results showed that patients who were rated as more emotionally engaged in relating their experiences and then reflecting on them by mid-session also had higher scores in the therapeutic alliance by the final part of that same session. An implication of this study is that the interpersonal factors facilitating elaboration of inner experience, including elements of warmth, safety, and analytic trust, are related to the development of early therapeutic alliance. These findings did not appear to be dependent on the patient’s psychopathology. This study is one in a growing line of research exploring how patients speak rather than just the content of what they say.

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Published
2019-04-19
Section
Special Section: the legacy of Jeremy Safran
Keywords:
Therapeutic alliance, Referential process, Referential activity, Therapeutic linguistic dimensions
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How to Cite
Negri, A., Christian, C., Mariani, R., Belotti, L., Andreoli, G., & Danskin, K. (2019). Linguistic features of the therapeutic alliance in the first session: a psychotherapy process study. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(1). https://doi.org/10.4081/ripppo.2019.374