Russell, Katie; (1998) Therapeutic alliance on an in-patient eating disorders unit. Doctoral thesis (D.Clin.Psy.), UCL (University College London).

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Abstract

This study aimed to enhance understanding of the therapeutic alliances developed for patients undergoing treatment for eating disorders. The aims were two-fold: Firstly, this study aimed to examine whether family functioning and a number of treatment and pretreatment variables were associated with the reported alliances and; secondly, this study aimed to explore the congruence between patient and staff ratings of the therapeutic alliance. 21 patients (18 in-patients and 3 day-patients, with a mean age of 20.7 years) participated in this study. All participants were approached individually, and following their consent, filled in the questionnaires. The patients key-nurses and therapists were also given the Working Alliance Inventory. Neither family functioning nor any of the pretreatment or treatment variables, with the exception of weight from target, were associated with the therapeutic alliance. The therapeutic alliance was found to be related to self-esteem, but only for the patients' ratings of their relationships with key-nurses - those patients who reported poor self-esteem also reported their alliance with the key-nurses as lower. Patients rated their alliances with therapists as better than with key-nurses. There was also a significant difference between the patients' and key-nurses' ratings of their relationships - key-nurses rated the relationship as higher quality than the patients. This difference was not found with patients' and therapists' ratings of the relationship. None of the variables in this study were associated with these discrepancies.

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