Clinician and Client Characteristics Associated with Client-Reported Working Alliance in Individuals with Eating Disorders

Date of Submission

2020

Degree Type

Dissertation

Department

Psychology

Department Chair

Stephanie Felgoise, Ph.D., ABPP

First Advisor

Michelle Lent, Ph.D.

Second Advisor

Stephen Poteau, Ph.D.

Third Advisor

Michael Gray, Ph.D.

Abstract

Eating disorders carry the highest mortality rate of any psychiatric illness, and empirically supported treatment options are limited.  Additionally, eating-disorder treatments can be expensive, and access to services remains limited for many living with these disorders.  Though working alliance is considered to be a critical element of treatment success in most psychotherapeutic approaches, the role of working alliance in eating-disorder treatment is less well understood.  The current study aimed to better understand the relationship between upward social comparison, eating-disorder symptomatology, and clinician characteristics in patient-reported working alliance for individuals with eating disorders. Participants (N = 77) were adults in treatment and were recruited from Facebook eating-disorder groups, local eating-disorder advocacy events, and ResearchMatch. Results suggest that working alliance was not significantly related to any of these variables (p > 0.05); however, participants reported that clinician weight status was significantly correlated with working alliance (p = .045), though this result was not significant after controlling for participant weight status.  Clinician weight status may be an important factor in working alliance and treatment success in populations seeking treatment for eating disorders. Future research should further examine the factors that contribute to the development of strong working alliance within this population.

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