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MINI REVIEW article

Front. Psychol.
Sec. Psychology for Clinical Settings
Volume 15 - 2024 | doi: 10.3389/fpsyg.2024.1465017
This article is part of the Research Topic The Interaction between Self and Other in the Clinical Setting: The Role of Inter-Subjectivity View all 4 articles

The effects of therapeutic alliance in major depressive disorder: A literature review

Provisionally accepted
Giovanni Videtta Giovanni Videtta 1Silvia Busilacchi Silvia Busilacchi 2Giulia Bartoccioni Giulia Bartoccioni 2*Luisa Cirella Luisa Cirella 3*Ylenia Barone Ylenia Barone 2*Giuseppe Delvecchio Giuseppe Delvecchio 2
  • 1 Department of Biomedical Sciences for Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
  • 2 Department of Neuroscience and Mental Health, IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Lombardy, Italy
  • 3 Healthcare Professionals Department, IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, Milan, Italy

The final, formatted version of the article will be published soon.

    The therapeutic alliance is the collaborative relationship between therapist and patient that is widely investigated in clinical research. Therapeutic alliance has emerged as a crucial component of effective psychotherapeutic interventions, particularly for Major Depressive Disorder (MDD), where its role seems to be multifaceted. In this context, we reviewed the main literature evidence on the role of therapeutic alliance in MDD. The record search was performed on three datasets: PubMed, Web of Science and PsychInfo. Most of the reviewed studies highlighted that therapeutic alliance was a good predictor for clinical outcomes, improving MDD symptoms, preventing relapses and promoting more adaptive functioning. In contrast, a restricted number of reviewed studies reported that the clinical improvement influenced the therapeutic alliance between therapist and patient at different points during the treatment. Therefore, overall, the results seem to suggest the presence of a bidirectional influence between the therapeutic alliance and symptom improvement, reporting that a stronger alliance often predicts better outcomes, while symptom reduction can enhance the alliance. However, to better interpret the results of this review, some methodological limitations should be considered, including the use of different approaches, measurements and clinical outcomes to investigate therapeutic alliance, as well as the limited investigation of temporal precedence between therapeutic alliance and clinical outcomes. In conclusion, future studies are warranted to mitigate these limitations and to better clarify the role of therapeutic alliance in MDD and its potential implication for clinical practice.

    Keywords: Major Depressive Disorder, Therapeutic Alliance, clinical setting, clinical psychology, Interaction

    Received: 15 Jul 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Videtta, Busilacchi, Bartoccioni, Cirella, Barone and Delvecchio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Giulia Bartoccioni, Department of Neuroscience and Mental Health, IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, 20122, Lombardy, Italy
    Luisa Cirella, Healthcare Professionals Department, IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
    Ylenia Barone, Department of Neuroscience and Mental Health, IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, 20122, Lombardy, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.