Neuroanalysis of therapeutic alliance in the symptomatically anxious: The physiological connection revealed between therapist and client

Abstract

This study was an attempt to establish neurophysiological correlates, particularly brain activity, during high therapeutic alliance (TA) between client and therapist. The aim was to assess electroencephalography (EEG) activity in clients with symptomatic anxiety during high TA using skin conductance resonance measurements from both client and therapist. Thirty clients, aged 43.8 ± 11.5 years (males: n=15 females: n=15), underwent six, weekly, 1-hour sessions (180 hours of repeated measures). The EEG activity was measured from the prefrontal, temporal, parietal and occipital sites during the sessions. State and trait anxiety, Working Alliance Inventory (WAI) and heart rate measures were obtained before and after each session. Prefrontal, parietal and occipital sites were associated with TA. Anxiety and heart rate were found to decrease after therapy, and for both the client and the therapist, the WAI score increased significantly in later sessions. The results are discussed from the perspective of further understanding the neurophysiological associations to TA.