Alliance and technique in short-term dynamic therapy

We review existing studies on the extent to which the alliance and techniques predict the outcome of short-term dynamic psychotherapy (STDP). Although the alliance has been found to relate to outcome in diverse psychotherapies, evidence for its role in STDP is more inconsistent. Studies of technique factors have provided support for the relation of competence with exploratory interventions to outcome. Less support for the role of specific transference interpretations was found. Little empirical support exists for the notion that the technical factors are most potent in the context of a positive alliance, although adequate studies of this interaction are scarce. Similarly, adequate studies that attempt to tease apart the extent to which technical factors influence the alliance, and vice versa, are also rare. Despite the methodological limitations of research in this area, the fact that there are some consistent findings relating techniques to outcome suggests that nonspecific relationship factors do not by themselves account for the changes found over the course of STDP. Moreover, such findings encourage additional efficacy and process research on STDP. Some suggestions for future research are presented.