The therapeutic alliance is an established predictor of psychotherapy outcome. However, alliance
research in the treatment of eating disorders has been scant, with even less attention paid to correlates of
alliance development. The goal of this study was to examine the relation between specific patient
characteristics and the development of the alliance in 2 different treatments for bulimia nervosa (BN).
Data derive from a large,randomized clinical trial comparing cognitive-behavioral therapy (CBT) and
interpersonal therapy (IPT) for BN. Across both treatments, patient expectation of improvement was
positively associated with early- and middle-treatment alliance quality.In CBT, baseline symptom
severity was negatively related to middle alliance.In IPT, more baseline interpersonal problems were
associated with poorer alliance quality at midtreatment.