The Impact of Shame on the Therapeutic Alliance and Intimate Relationships

Rebecca S. A. Black, David Curran, Kevin F. W. Dyer

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)



This study examined the role of shame coping styles and state shame in predicting the therapeutic alliance and intimate relationship functioning in individuals with mental health problems.


A sample of 50 treatment-receiving adults aged 21 to 67 years with a mix of common mental health difficulties was recruited from a clinical psychology service. Participants were given questionnaire measures of shame states, shame coping styles, intimate relationship functioning, and the therapeutic alliance.


Regression analyses indicated that the shame coping strategy of physical and psychological withdrawal was the primary risk factor for development of a less effective therapeutic alliance. Both withdrawal and attack self coping styles were significant predictors of impaired intimate relationship functioning.


These findings have implications for the theoretical role of shame in mental health presentations as well as the potential for internalizing shame coping styles (i.e., withdrawal, attack self) to act as a barrier to successful therapy and interpersonal relationships. The inclusion of shame-focused assessments and interventions in the initial stages of treatment with clients exhibiting these strategies could improve prognosis.

Original languageEnglish
Pages (from-to)646 - 654
Number of pages9
JournalJournal of Clinical Psychology
Issue number6
Early online date04 Feb 2013
Publication statusPublished - Jun 2013

Bibliographical note

© 2013 Wiley Periodicals, Inc.

ASJC Scopus subject areas

  • Clinical Psychology
  • Arts and Humanities (miscellaneous)


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