Celen, Ceylan (5/13) Therapist characteristics as predictors of the working alliance: therapist trait empathy and therapist complex thinking (Lisa Wallner Samstag, Ph.D.; Elizabeth Kudadjie, Ph.D.; Nicholas Papouchis, Ph.D.; Sara Haden, Ph.D.)
This dissertation sought to investigate the impact of therapist trait empathy and therapist complex thinking on the quality of the therapeutic relationship. The participants were 16 trainee therapists and their clients (N = 92). Therapist participants completed measures of trait empathy (Interpersonal Reactivity Index; Davis, 1980) and complex thinking (Learning Environment Preferences; Moore, 1989). In a nested design, alliance ratings were collected from 92 therapist-client dyads. Alliance was scored in four different ways: client-rated and therapist-rated alliance scores (mean ratings from the Working Alliance Inventory-short form) and two co-alliance scores (a correlation and a difference score of client and therapist ratings of a given session). A series of mixed-effects analyses showed that only cognitive trait empathy-fantasy was associated with client-rated alliance, and that it was associated with lower ratings of that alliance. There were no significant associations between the predictors and therapist-rated alliance. Co-alliance, when measured as the correlation scores between the therapist and the client ratings of the alliance, was associated with cognitive trait empathy-perspective taking and affective trait empathy-empathic concern. More specifically, cognitive trait empathy-perspective taking was associated with lower correlation scores, while affective trait empathy-empathic concern was associated with higher correlation scores. Co-alliance, when measured as the difference scores between the therapist and the client ratings of alliance, was associated with cognitive trait empathy-fantasy and complex thinking. More specifically, cognitive trait empathy-fantasy was associated with higher co-alliance difference scores, while complex thinking was associated lower co-alliance difference scores. These results demonstrate that therapist's purely cognitive understanding of the client's frame of reference neither facilitates the alliance, nor increases the relative agreement between the therapist and the client regarding their agreement on the relevant tasks and goals of the therapy, as well as the emotional bond between them. In contrast, therapist affective trait empathy increases the relative agreement of the dyad. Similar to therapist affective trait empathy, results demonstrate that therapist complex thinking improves the degree to which the dyad is in sync. The results suggest that affective trait empathy is an essential skill for therapists. Training programs should both encourage students to trust their emotions and focus on teaching their students not only therapy techniques and the cognitive skills to think multidimensionally and creatively to facilitate the therapeutic relationship but also how to use their affective capacities to do so.
