Therapeutic Alliance and Outcome in Complicated Grief Treatment

In this study, we examined the role of the therapeutic alliance in complicated grief treatment (CGT), an efficacious psychotherapy for complicated grief. Using data from a previously reported randomized controlled trial, we explored whether the alliance-outcome relationship differs by treatment group among treatment completers assigned to either CGT (n = 35) or interpersonal psychotherapy (IPT) (n = 34). Early alliance (at week 4) was associated with a reduction in grief symptoms in CGT but not IPT. The difference in the alliance-outcome relationship was accounted for by goal/task items on the Working Alliance Inventory. The contribution of a positive alliance, particularly the agreement on goals and tasks, may be more significant in CGT, a highly structured treatment, than IPT in reducing symptoms of complicated grief.