Therapeutic Alliance and Post-Intervention Outcomes in a Sample of South Asian Canadians Receiving Culturally-Adapted CBT: Considering Client and Therapist Perceptions

Introduction: Culturally-adapted cognitive behavioural therapy (CaCBT) aims to incorporate cultural considerations into the CBT model, particularly for ethnic minorities. The current state of literature somewhat supports that client perception of therapeutic alliance may be more important in predicting greater improvement post-intervention, however some work may suggest therapist perception is also important. Authors conducted a sub-analysis of a CaCBT RCT for South Asians to explore the influence of therapeutic alliance.

Methods: Bivariate correlational analyses and ANCOVAs are underway, using data from 146 South Asian Canadians enrolled in the original RCT. Variables of interest include depression, anxiety, disability, and somatic symptoms, with timepoints of interest being baseline, 12-weeks (post-intervention), and a 36-week follow-up.

Results: Preliminary results suggest that therapist perception of therapist-client alliance or relationship is not significant in predicting improved client outcomes. However, preliminary results highlight that client perception of therapeutic alliance is statistically significant for depression and anxiety, but not for disability and somatic symptoms.

Conclusions: Preliminary findings suggest that client perception of therapeutic alliance holds more importance in client therapeutic outcome improvement than therapist perception does. Future research should consider whether this is the case for other therapy modalities and ethnicities and aim to integrate qualitative work for client feedback and satisfaction, while this work helps build a foundation for considering how important client perception of therapist-client relationship is for their therapeutic improvement.