Volume 25, Issue 1

A Matter of Perception: Patient and therapist value differences impact working alliance and outcome

Patient values are important in psychotherapy, though few therapists address this issue—particularly in relation to his or her own values. Given that the idea of therapist neutrality has been abandoned, practitioners seeking to provide evidence-based and culturally sensitive care are limited by the small existing values literature. This study explored the impact of patients' perceptions of value differences, in addition to actual value differences between 29 patient-therapist dyads, on working alliance and outcomes. Actual value differences between patients and therapists were not significantly associated with outcome or alliance. However, patients' perceived value similarity was associated with stronger therapeutic alliance. Findings are discussed in terms of implications for clinical practice, including the importance of discussing expectations and preferences with patients.

values, expectations, evidence-based practice, treatment outcome, working alliance

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