In this study, we assessed the patient–oncologist relationship, conceptualized as the working alliance from a dyadic perspective, and its relation to locus of control.

One hundred and three oncologist–patient dyads were recruited. Measures included a sociodemographic and medical questionnaire; the “internal, powerful others, and chance” locus of control scale; and the working alliance inventory.

Application of the actor–partner interdependence model yielded 2 actor effects: a positive association between oncologist “internal” locus of control and oncologist working alliance, and a negative association between oncologist “chance” locus of control and oncologist working alliance. It also yielded one partner effect: a positive association between oncologist “internal” locus of control and patient working alliance.

The actor–partner effect suggests that oncologists’ locus of control has a role in the establishment of the patient–oncologist working alliance; oncologists’ internal locus of control is a dominant factor affecting not only their own perceived alliance but patients’ perceived alliance as well.

Working Alliance is defined as the emotional bond and the agreement on therapeutic goals and tasks between patients and therapists. Despite the wide use of the construct of working alliance in research on psychotherapy, few studies have investigated the role of working alliance in influencing adherence to pharmacotherapy, and drug attitude. A deeper knowledge of the interplay between working alliance and drug attitude could help to challenge low adherence to psychopharmacological treatments in Major Depressive Disorder.

This study aimed to investigate the relationship between working alliance and drug attitude in patients with Major Depressive Disorder.

27 patients admitted in the Psychiatric Unit of Careggi with diagnosis of Major Depressive Disorders were enrolled. Working Alliance Inventory - patient version (WAI-P), Drug Attitude Inventory (DAI) and Beliefs about Medicines (BMQ) were administered. Pearson’s correlation was used to assess relationships between variables.

A significant positive correlation was detected between BMQ total scores, DAI total scores and WAI-P task, bond, and goal subscales.

Such preliminary data suggest a relationship between Working Alliance and drug attitude. This could contribute to provide tools to challenge low adherence to psychopharmacological treatments in patients with Major Depressive Disorder.

No significant relationships.

Digital technologies have been widely acknowledged as a potentially useful resource for increasing mental healthcare access. The working alliance is a key influence on outcomes in conventional psychotherapy, but little is known about therapists’ experiences of forming an effective working alliance in blended interventions that involve in-person psychotherapy and a digital programme.

To investigate psychological well-being practitioners’ (PWPs’) experiences of the working alliance in a trial of blended cognitive–behavioural therapy (b-CBT) for depression. Trial registration ISRCTN12388725.

Semi-structured qualitative interviews were conducted with 13 PWPs who delivered b-CBT in a two-arm, non-inferiority randomised controlled trial investigating the effectiveness of b-CBT compared with face-to-face CBT. Thematic analysis was used to analyse the data.

Participants reported four facilitating factors when building and maintaining a working alliance in b-CBT: having more time to deliver treatment, access to a wider toolkit, capacity to tailor components of b-CBT and receiving appropriate training and support. Participants also identified four barriers to building and maintaining a working alliance: time and resource constraints, usability challenges, limited flexibility to tailor the digital programme to patients’ needs and lack of confidence in delivering b-CBT.

Our study is the first specifically to investigate practitioners’ perceived facilitators and barriers to forming a working alliance in b-CBT for depression. Findings suggest that PWPs’ experiences of the working alliance can be improved by: accounting for the time required to deliver b-CBT in service workflows to reduce time pressures; increasing opportunities to tailor the digital programme through offering transdiagnostic tools and adaptable features; and providing appropriate b-CBT training and technical support.

A positive therapeutic (or working) alliance has been associated with better outcomes for clients in the psychotherapeutic and traumatic brain injury (TBI) rehabilitation literature. The aim of this pilot study was to gain an understanding of the therapeutic alliance in community rehabilitation from the perspectives of adults with TBI and their close others who have completed a community rehabilitation programme.

This study used a constructivist, qualitative methodology which applied grounded theory analysis techniques. Using purposeful sampling, three pairs of participants (adults with TBI and close others) who had finished a community rehabilitation programme completed separate in-depth interviews which were transcribed verbatim and progressively analysed using a process of constant comparison.

A preliminary framework illustrating participants’ experience of a therapeutic alliance was generated, comprising three interconnected themes: being recognised as an individual, working together and feeling personally connected. All participants viewed being able to work together as important in their experience of community rehabilitation and described features that helped and hindered the alliance.

These pilot study results demonstrate the importance of the therapeutic alliance to the rehabilitation experience of individuals with TBI and those close to them.

The current study examined the association of demographic/preinjury, injury-related, and cognitive behavior therapy (CBT) process variables, with anxiety and depression symptom change in traumatic brain injury (TBI)-adapted CBT (CBT-ABI).

The audio recordings of 177 CBT-ABI sessions representing 31 therapist–client dyads were assessed from the independent observer perspective on measures of working alliance, homework engagement, and therapist competency in using homework.

Linear regressions showed that older client age, longer post-TBI recovery period, better executive functioning, higher levels of client homework engagement, as well as higher levels of therapist competence in reviewing homework were associated with greater improvement in anxiety and/or depression symptoms.

CBT-ABI is a promising treatment for post-TBI depression and anxiety. The current study highlights how therapists can enhance CBT-ABI effectiveness, specifically: comprehensive facilitation of client homework engagement with emphasis on homework review, and accommodation of executive deficits. The current study also suggests that the role of client age and the length of post-TBI recovery period require further investigation.

1. (1) Readers will consider the role of common factors in treatment for social anxiety disorder.

2. (2) Readers will learn about how different common factors may interact with each other.

3. (3) Readers will be encouraged to consider how the therapeutic relationship may manifest in a unique manner in treatment for social anxiety.

A working alliance (WA) is considered an essential factor in therapeutic relationships, relating to the mutual and interactive aspects of the relationship. In the medical setting, a WA has been found to be related to various positive outcomes; however, it has previously been investigated solely from the patient's perspective. The aim of the current study was to measure the concept from both sides of the patient–medical staff interaction.

Physicians, nurses, and advanced cancer patients completed the Working Alliance Inventory–Short Revised.

Some 32 physicians, 39 nurses, and 52 advanced cancer patients completed the study. Senior staff members rated the WA higher than trainees, both among physicians and nurses. Physicians and nurses rated the “bonds” subscale highest, while patients rated “goals” at the highest level. In addition, a significant difference was demonstrated between physicians and patients, with patients rating the WA higher.

These preliminary findings demonstrate different perspectives among advanced cancer patients and medical staff interactions. Future studies should investigate the interactive aspects of the WA concept in the medical setting.

Awareness of the working alliance in patient–staff interactions may improve the quality of treatment given to patients confronting cancer.