Psychotherapist behaviours contributing to alliance strength and client dropout in Australia

Although the relationship between alliance and dropout has been investigated, the impact of direct, observable psychologist behaviours has scarcely been examined, particularly from the client’s perspective. Objective: To explore client perceptions of psychologist behaviours, their association with therapeutic alliance and their impact on the odds of dropout. Method: Participants rated their psychologist on a list of observable behaviours, and completed a measure of alliance via an online survey. Ratings of psychologist behaviours were examined through principal components analysis and correlational analysis was conducted on the resultant factors and working alliance ratings. Logistic regression was then used to examine the predictive capacity of the factors in predicting odds of dropout. Results: All psychologist behaviour factors were significantly correlated with the working alliance measure to varying degrees. Higher factor scores for counselling microskills and respect for autonomy significantly predicted lower odds of dropout, while higher factor scores for posture and disrespect significantly predicted higher odds of dropout. Conclusion: The current findings provide the first known evidence of a direct link between specific, observable psychologist behaviours and dropout. This further supports the importance of developing these specific interpersonal skills of psychologists and regularly assessing these from the client’s perspective. Replication of this study is recommended in different samples, with both traditional and e-mental health delivery of services.