Patients’ Self-presentational Tactics as Predictors of the Early Therapeutic Alliance

Objectives: The early therapeutic alliance is an important predictor for therapy outcome. However, knowledge about predictors of the therapeutic alliance is still limited. We examined if patients’ self-presentational behaviors can predict the early therapeutic alliance.

Method: Videotaped intake interviews of 60 randomly selected patients were coded for patients’ self-presentational tactics. The therapeutic alliance was measured with the Bern Post-Session Report.

Results: From the therapists’ perspective, Agenda setting and Self-promotion were positively related and Supplication was negatively related to the therapeutic alliance. From the patients’ perspective, Agenda setting was negatively related and Self-promotion was positively related to the therapeutic alliance. Provoking a response from the therapist was unrelated to the therapeutic alliance as judged from both therapist and patient perspectives. Correlations were of small-to-moderate size. These findings have important implications for building a constructive therapeutic alliance and identifying patients’ needs.

Conclusions: Patients’ self-presentational behavior is a promising predictor of the early therapeutic alliance.