The state of therapeutic alliance at a neurophysiological level in the symptomatically anxious : effect on the therapeutic process

University of Technology, Sydney. Faculty of Science.NO FULL TEXT AVAILABLE. This thesis contains 3rd party copyright material. The hardcopy may be available for consultation at the UTS Library.NO FULL TEXT AVAILABLE. This thesis contains 3rd party copyright material. ----- This study attempted to establish neurophysiological correlates during high therapeutic alliance (TA) between client and therapist. Therapeutic Alliance is the special relationship established between client and therapist comprised of interactive relational and integrative technical aspects, which sets it apart from other relationship constructs (Horvath & Greenberg, 1994). It is also the essential healing element common to all forms of psychotherapeutic modalities (Bozarth & Wilkins, 2001). The aim of this study was to assess neurophysiological variables such as electroencephalography (EEG) activity, heart rate and heart rate variability (HRV) (a measure of autonomic activity), skin conductance and blood pressure in clients with symptomatic anxiety during high TA. This thesis also investigated links between lifestyle, behaviours, mood states and anxiety as predictors of developing a positive therapeutic alliance (TA). Thirty clients aged 43.8 ± 11.5 years (males: n= 15 females: n=--= 15) underwent six, weekly 1-hour psychotherapy se sions ( 180 hours of repeated measures). Simultaneous physiological measures of skin conductance resonance (SCR) were continuously recorded du1ing each psychotherapy session to establish the therapeutic index (TI), a measure of (TA). EEG was measured from the pre-frontal, temporal, parietal and occipital sites during the sessions. Simultaneous cardiac data was also obtained during the entire session. State and trait anxiety, Working Alliance Inventory (WAI) and cardiac measures were also obtained before and after each session. The Profile of Mood States (POMS) and Lifestyle Questionnaire (LAQ) were administered at the start of therapy. Results showed that the pre-frontal (p=0.045), parietal (p=0.01) and occipital sites (p=0.045) were significantly associated with high TA. State anxiety (p=0.0004) and heart rate (p