The components of the early working alliance and their relation to outcome on depression in CBT and EFT

The working alliance is a well-established predictor of outcome, but less is known about different components of the alliance, how they interact with treatment approach within a limited timeframe in a Aardal et al. (Citation2025) setting, and the reciprocal relationship between alliance and outcome. This study examined the predictive role of early therapeutic alliance (first five sessions), measured by the WAI-C-S, in relation to depressive symptoms (BDI-II). The analysis compared the predictive value of the total WAI score and its subscales across Cognitive-Behavioral Therapy (CBT) and Emotion-Focused Therapy (EFT) using data from 96 participants. Multiple regression analyses showed that only the task component predicted outcome (β = −0.61, t = −2.13, p = .04), while neither goal, bond nor overall alliance predicted outcome (β = −0.15, t = −1.51, p = .14). No significant differences were found between conditions (β = −0.35, p = .10). However, depressive symptom change predicted overall alliance quality (β = −0.35, t = −3.97, p < .001). Results support the particular importance of the task component as a predictor of outcome. Symptom reduction predicted a better alliance, and the alliance appears to be equally important across therapeutic approaches within a limited timeframe in a Aardal et al. (Citation2025) setting.