Alliance, technique, and their interactions in predicting outcome of behavioral, cognitive, and brief dynamic therapy

With depressed elderly patients treated in behavioral (BT), cognitive (CT) or brief dynamic therapy (BDT), the prediction of outcome by alliance, technique (exploratory and supportive), and their interactions was examined. The alliance was rated on the CALPAS-R, and technique on the Inventory of Therapeutic Strategies (ITS). In BT, pretherapy depression levels and alliance predicted outcome, as did more exploratory interventions provided in the context of poorer alliances at midtherapy. In CT, alliance and exploratory interventions predicted outcome throughout treatment, as did more exploratory interventions provided in the context of poorer alliances at midtherapy. In BDT, some alliance dimensions predicted outcome throughout treatment, as did exploratory techniques at midtherapy; furthermore, the use of exploratory interventions in the context of better alliances tended to predict better outcomes, a finding contrary to the ones observed in BT and CT. Therefore, differential processes were observed across therapy conditions and phases.