An Investigation of the Relationship between Therapist Characteristics and Alliance in Group Therapy for Individuals with Treatment-Resistant Auditory Hallucination

Alliance is a well-studied construct across psychotherapy research; however little research has investigated predictors of alliance in a group context. This study investigates the relationship between therapist characteristics and behaviors in 65 individuals with schizophrenia receiving outpatient group therapy for treatment-resistant auditory hallucinations. Trained raters coded 120 sessions of cognitive behavioral therapy or supportive therapy for therapist warmth and friendliness, therapist exploration and negative therapist attitude. The results showed that higher levels of therapist warmth and friendliness in sessions four, and lower levels of negative therapist attitude in sessions two and three predicted stronger alliance at week six. Therapist exploration in sessions one to five did not predict alliance at week six. Additional analyses indicated that lower negative therapist attitude in sessions two and five was associated with higher post- treatment symptom scores. Therapist characteristics did not predict treatment attendance or participation. Implications for clinical practice are discussed