Original ArticlesThe Impact of Patients' and Therapists' Views of the Therapeutic Alliance on Treatment Outcome in PsychotherapyTschuschke, Volker PhD∗; Koemeda-Lutz, Margit PhD†; von Wyl, Agnes PhD‡; Crameri, Aureliano PhD‡; Schulthess, Peter Lic. Phil. I†Author Information ∗Department of Medical Psychology, University Hospital of Cologne, Cologne, Germany †Swiss Charter for Psychotherapy ‡Department of Applied Psychology, Zurich University of Applied Science, Zurich, Switzerland. Send reprint requests to Volker Tschuschke, PhD, Department of Medical Psychology, University Hospital of Cologne, Kerpener Straße 68, 50937 Cologne, Germany. E-mail: [email protected]. The Journal of Nervous and Mental Disease: January 2020 - Volume 208 - Issue 1 - p 56-64 doi: 10.1097/NMD.0000000000001111 Buy Metrics Abstract This article reports about the role of psychotherapists in creating a good enough therapeutic alliance as the basic task for other therapeutic factors come into play. Data from a naturalistic study involving 237 patients treated by 68 psychotherapists using 10 different psychotherapy approaches were analyzed in a process-outcome research design. The results show that therapists had to adapt their alliance perspectives to patients' level of alliance ratings as treatments progressed. Treatment concepts did not play a role in outcome. The view of a similar quality of the therapeutic alliance seems to be an indispensable precondition for favorable treatment outcomes. Successful treatments were conducted more often by therapists who showed significant convergence of alliance ratings over time, whereas discrepant alliance ratings correlated significantly with unsuccessful treatments. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.