The aim of this study was to investigate the role of patient coping style in psychological therapy,
in particular whether patient coping style was associated with therapeutic alliance and
therapeutic outcome after six sessions of therapy.
The study was conducted in a naturalistic setting. All outpatients who opted in see a
psychologist in a general adult clinical psychology department over a four month period were
invited to participate. Patients who agreed to participate completed a pre-therapy questionnaire
to measure their coping style. After three sessions of therapy, participants and their
psychologists completed independent measures of a therapeutic alliance scale. Participants
repeated the pre-therapy coping questionnaire after their sixth session of therapy and another
measure (already administered pre-therapy as part of routine practice) to assess for changes in
their levels of psychological distress.
Patients with a strong reliance on cognitive approach coping strategies were found to have
formed a good therapeutic alliance with their psychologist and to have experienced a reduction
in their symptoms after six sessions of therapy. Conversely, patients with a strong reliance on
cognitive avoidance coping strategies were found to have formed poorer therapeutic alliances
with their psychologist and to have experienced smaller reductions in their symptoms after six
sessions of therapy. Further examination of the results suggested that the therapeutic alliance
might be a possible mediating factor between patient coping style and therapeutic outcome after
six sessions, although a statistical examination of this was not viable.
The results suggested that aspects of patient coping style might have an important role in the
formation of the therapeutic alliance and therapeutic outcome after six sessions of therapy. The
methodological limitations and clinical implications of these findings are discussed.