CONCEPTUALIZATIONS OF HELP-TAKING AND PATIENT RESPONSE TO PSYCHOTHERAPY

Abstract

This study measured conceptualizations of help-taking in two different ways--through the recall of experiences with past helpers and the report of help desired from a current therapist. The recall of past help more strongly predicted the strength of the therapeutic alliance established during the initial phase of analytically oriented individual treatment. The kind of help offered by past helpers accounted for 36% of the variance in the strength of the therapeutic alliance, and how positive one felt about help received in the past accounted for an additional 6.7% of the total variance.;When past helpers were recalled and/or a current therapist was expected to focus on being sympathetic over objective, wait for the other's lead over initiating topics, stress feelings over actions, and understand problems over solving them, the therapeutic alliance was significantly more likely to flourish. This "therapeutic ideology" is consistent with psychoanalytic theory of technique. All the therapists in this study described themselves as analytically oriented. It was therefore concluded that when patient and therapist share a similar therapeutic ideology, the formation of an effective alliance is enhanced.;Patients who established a stronger therapeutic alliance were significantly more likely to recall help received in the past as effective or expect their current therapy to be successful. This suggests a greater willingness and/or capacity to profit from the therapists' offer to help.;Patients who formed a strong therapeutic alliance also recalled approaching past helpers for help rather than being approached by them. Apparently, patients who experience a strong need to communicate their distress to a helping person develop a positive relationship with the therapist.;That help-taking conceptualizations revealed through the recall of past experiences were more highly correlated with a positive therapeutic alliance than those revealed through the report of current expectations suggests that patients' report of help currently expected from a therapist may be a more conscious but less veridical reflection of internalized help-taking conceptualizations. It is possible that current help-taking expectations may be distorted by patients' wish to impress their therapists as "good" (e.g., socially desirable) in order to feel liked and accepted by them.