B - 116 What Factors Predict Clinician Ratings of the Alliance in Neuropsychological Settings?

Abstract Objective The study aimed to identify variables associated with clinician ratings of the working alliance in neuropsychological assessment settings. Method The study utilized a cross-sectional design and survey method to evaluate hypotheses. Participants (n = 224) recruited from neuropsychology listservs were clinicians who saw an adult patient in the context of a neuropsychological evaluation within the past month. Clinician demographics, patient demographics, evaluation variables (e.g., time spent in evaluation, referral question, evaluation setting) and ratings of the salience of the alliance were collected via participant self-report. The Working Alliance Inventory – Neuropsychology Revised (WAI-NP-R) (α = 0.93) created for this study served as the primary outcome. Results Between-subjects ANOVA revealed that clinician-patient match on gender demographics was associated with higher clinician ratings of the working alliance (F(1, 218) = 6.73, p = 0.010, ηp2 = 0.03). Post hoc tests revealed that ratings of the working alliance were significantly higher for male clinicians with female patients (M = 104.26, SE = 2.54) than for female clinicians with female patients (M = 92.97, SE = 1.89), mean difference = 11.288, 95% CI [2.65, 19.92], p = 0.004. In a hierarchical regression analysis both examiner age (β = 0.297, p < 0.001) and examiner rating of importance of the alliance (β = 0.164, p = 0.010) were independent predictors of alliance ratings. Conclusions The study found that clinician ratings of the working alliance were associated with clinician age, gender, and investment in the alliance. Findings add to a limited but growing body of literature on the alliance within neuropsychology.