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In Here and Out There: Systemic Alliance and Intersession Processes in Psychotherapy

The processes clients engage in between therapy sessions (referred to as intersession processes; ISPs) are empirically supported as influential factor in psychotherapy. The current study examined the impact of the therapeutic alliance—both the individual alliance and the systemic alliance—on client engagement in ISP-thoughts, ISP-actions, and client perceptions of therapy progress. Eighty-one therapy clients provided responses regarding these therapy process variables, and results revealed that higher ratings of client/therapist alliance (referred to as “self-alliance”), and higher ratings of alliance between one’s social network and therapy (referred to as “other-alliance”) were related to greater engagement in ISP-actions, but not ISP-thoughts. In addition, an interaction factor was supported wherein those who reported high self-alliance and high other-alliance also engaged in greater ISP-actions, but this association was not found when other-alliance was reported to be low. Clients’ positive perceptions of therapy progress were associated with greater engagement in ISP-thoughts, ISP-actions, and higher ratings of self- and other-alliance. Discussion and implications are offered for how therapists may be more effective at monitoring and promoting engagement in ISPs and aligning with clients’ many systems.