Basic psychological needs satisfaction, working alliance, and early termination in psychotherapy

Abstract

The goal of this study was to evaluate the relationship between basic psychological needs satisfaction and working alliance in psychotherapy and to determine whether client ratings of basic needs and working alliance during psychotherapy were associated with early termination of therapy. Former psychotherapy clients (n = 87) completed a semi-structured interview regarding basic needs satisfaction in therapy, working alliance and dropout status. Participant ratings on the Basic Needs Satisfaction in Psychotherapy scale (BNSP) and the Retrospective Working Alliance Inventory – Short (RWAI-S) were significantly correlated (r = .77) in our sample. A comparison of intercorrelations between working alliance subscales and basic needs subscales indicated higher factorial distinctiveness within the basic needs measure. T-tests comparing those who terminated psychotherapy early with those who had planned endings on scores on the BNSP and RWAI-S were significant (Cohen’s d = .65 and 1.82, respectively). Results suggest that the basic needs measure might tap into a wider breadth of the therapist and client interaction than the RWAI-S.

Keywords:

• Self-determination theory
• working alliance
• dropout
• basic psychological needs
• common factors

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Beth Keleher is a doctoral-level student in clinical psychology at the University of Waterloo. Her research interests include features of the therapist–client relationship and their relation to psychotherapy process and outcome. Currently, her research focuses on applying a Self-Determination Theory framework to better understand the factors that influence client motivation to engage with and persist in psychotherapy.

Jonathan Oakman is an associate professor of psychology at the University of Waterloo and a licensed clinical psychologist. His research interests include studying change in response to psychological interventions.

Kevin Capobianco is a doctoral-level student in clinical psychology working as part of the Psychological Intervention Research Team at the University of Waterloo. He is interested in understanding how psychotherapists typically go about conceptualizing their clients’ problems in their daily practice, as well as how therapists should go about doing so in order to improve therapy outcomes.

Walter Mittelstaedt , PhD, C Psych is the Director, Campus Wellness and an adjunct assistant professor at the University of Waterloo. He is a member of the Psychological Intervention Research Team in the Clinical Psychology Division with current interests in efficacy, effectiveness, and knowledge translation of psychotherapy research.