Alliance as a mediator of expectancy effects in short-term group psychotherapy

This study investigated whether the therapeutic alliance mediates between patient expectancy of improvement and the outcome of time-limited, short-term group psychotherapy. Data were drawn from a comparative trial of 2 forms (interpretive and supportive) of time-limited group therapy for complicated grief (W. E. Piper, M. McCallum, A. S. Joyce, J. S. Rosie, & J. S. Ogrodniczuk, 2001). Patients' outcome expectancy was based on individualized target objectives for treatment, and alliance was assessed from patient and therapist perspectives. The data were analyzed through the use of hierarchical linear modeling. Patient-rated alliance played a mediating role in the relationship between outcome expectancy and group benefit, suggesting that the expectancy-outcome association is expressed through the development of a collaborative relationship between the individual members and the group therapist.