The relationship between clients’ personality traits, working alliance and therapy outcome in a training context

Background Clients’ differences in personality include both psychopathology and normal personality variations and constitute an important factor for the therapeutic process and outcome. There is a lack of empirical data on the impact of clients’ personalities on therapeutic relationships and outcomes, particularly in a training context. Participants and procedure This longitudinal study investigated the relationships between client personality traits, changes in those traits after cognitive behavioral or psychodynamic short-term therapy, and clients’ perceived working alliances with their therapists and their clinical outcomes at a university training clinic in Sweden. Participants were 138 clients with moderate psychological symptoms. Personality traits were measured using the Health-Relevant Personality Inventory. Results The results showed that Antagonism, Impulsivity, Hedonic Capacity, and Negative Affectivity improved significantly during therapy, while Alexithymia did not. Pre-therapy personality traits were not related to perceived working alliances (Working Alliance Inventory) or therapeutic outcomes (Clinical Outcomes in Routine Evaluation Outcome Measure). Post-therapy personality traits negative affectivity, hedonic capacity and alexithymia were related to working alliance, and changes in personality traits were predictive of therapy outcome. The change in Hedonic Capacity and Negative Affectivity explained about 20% of the variance in post-therapy symptoms after controlling for pre-therapy symptoms. Conclusions The results suggest that therapeutic foci on hedonism (extraversion) and negative affectivity (neuroticism) could be important for working alliance formation and symptom reduction in therapy. Future research should examine whether changes in clients’ negative affectivity or hedonic capacity mediate the relation between perceived working alliance quality and clinical outcome in training and other psychotherapeutic contexts.

Abstract licence: CC BY-NC-SA

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