The effect of Oxytocin administration on patient-therapist alliance congruence: Results from a randomized controlled trial

Objectives: The effects of oxytocin (OT) administration on psychotherapeutic processes have thus far been elusive. This study explored the effect of OT administration on patient-therapist congruence of the working alliance. Method: Inpatients with mental disorders (N = 87) participating in a randomized controlled trial received OT (n = 44) or placebo (n = 43) intranasally twice a day, for four weeks. Patients and therapists rated the alliance after each session. Results: Oxytocin significantly moderated the level of agreement (b = −0.56, SE = 0.25, t = −2.30, p = 0.02), such that patients receiving OT demonstrated lower discrepancy (b = −0.73, p < 0.001) than did those receiving placebo (b = −1.30, p < 0.001). On the other hand, the mutual covariance of patient-therapist ratings across sessions was positive and significant for patients receiving placebo (b = 0.26, p = 0.01) but not for patients in the OT group (b = −0.06, p =.56). Conclusion: Oxytocin can reduce discrepancies of patient-therapist perceptions of the alliance, although additional studies are needed to explore OT's effect on alliance development over time. As alliance congruence is associated with therapy outcomes, such intervention may lead to enhancement of therapeutic gains.