Working Alliance for Clients with Social Anxiety Disorder: Relationship with Session Helpfulness and Within-Session Habituation

Authors

Sarah A. Hayes, University of Washington School of Medicine
Debra A. Hope, University of Nebraska-LincolnFollow
Melanie M. VanDyke, Saint Louis Behavioral Medicine InstituteFollow
Richard G. Heimberg, Temple UniversityFollow

ORCID IDs

Debra A. Hope

Document Type

Article

Date of this Version

2007

Citation

Cognitive Behaviour Therapy 36:1 (2007), pp. 34–42.

doi: 10.1080/16506070600947624

Comments

Copyright © 2007 Taylor & Francis. Used by permission

Abstract

It has been suggested that a strong working alliance encourages clients to take risks during therapy (Raue, Castonguay, & Goldfried, 1993). This encouragement may be important for clients who fear negative evaluations as they engage in risk-taking elements of therapy. This study examined the relationship between working alliance, session helpfulness, and measures of emotional processing in 18 clients undergoing cognitive behavior therapy (CBT) for social anxiety disorder. Results indicate a positive correlation between client-rated, but not observer-rated, working alliance and session helpfulness. Moderate levels of working alliance were associated with higher initial anxiety and deeper within-session habituation. Overall, a strong alliance was associated with clients engaging with the session and finding the session helpful. Implications for the use of CBT for social anxiety are discussed.