Curvilinear trajectory in patient coordination over the course of short- term psychotherapy

Michael A. Westerman

Research output: Contribution to journalArticlepeer-review


Two studies were conducted to investigate change in patients' contribution to the alliance over the course of short, term psychotherapy. Alliance assessments were made in terms of the coordination construct. Findings in Study 1 provided support for the hypothesis of a curvilinear pattern in which coordination scores are lowest (i.e., patients' contribution to the alliance is most problematic) during midphase and higher in the early and later phases of treatment. Results from Study 2 offered additional support for the curvilinear trajectory on the basis of a more rigorous examination of that issue. Other findings from Study 2, which included investigation of relations between the pattern of change in coordination and outcome, provided no indications that the curvilinear pattern was associated with improvement. Findings from the two studies suggest that the curvilinear pattern may be a reasonably general phenomenon that occurs in a wide range of short-term approaches. Discussion includes the idea that in many cases the curvilinear trajectory may reflect changes in patient behavior that are specific to the treatment process, rather than stable, generalizable alterations in interpersonal behavior.

Original languageEnglish (US)
Pages (from-to)206-219
Number of pages14
Issue number2
StatePublished - 1998

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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