Work

Examining specificity in psychotherapy: Open/hidden administration of alliance in experimentally induced guilt

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: OBJECTIVE: Placebo-controlled trials face significant challenges in psychotherapy research due to difficulties in creating credible placebo conditions and the inability of blinding therapists. We tested the open/hidden administration as an alternative approach to differentiate between specific and nonspecific treatment effects. METHOD: 68 healthy subjects were randomized to receive one session of person-centered therapy to implement therapeutic alliance either with their knowledge (open; n = 23), without their knowledge (hidden; n = 22), or no treatment (control; n = 23) following experimental guilt induction. The primary outcome was guilt responses after the guilt induction. Secondary outcomes were shame, pride, and affect responses. We hypothesized that both alliance conditions would reduce guilt compared to control, with no difference between alliance conditions. RESULTS: = 0.810, d = 0.07). Similar patterns emerged for shame and pride, but not for affect. CONCLUSION: These results provide evidence that the open/hidden administration offers a novel approach to test the specificity of treatment components in psychotherapy research. Furthermore, our findings indicate that the therapeutic alliance is effective regardless of the provision of a treatment rationale.

Source: Psychotherapy Research

DOI: 10.1080/10503307.2026.2686684

Authors: Emil Kane Nissen, Theresa Zehnder, Clara Wehlage, Jens Gaab

Institution: University of Basel

Language: English

Topic: Psychotherapy Techniques and Applications

Subfield: Clinical Psychology

Field: Psychology

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: Universität Basel, Society of Clinical Child and Adolescent Psychology