Over the last 20 years researchers have begun to recognise that other factors - apart from the kind of treatment used and the nature of people's mental-health problems - affect whether psychotherapy gets people better or not. Two of the most important factors are the therapeutic alliance - the relationship between a psychotherapist and their client - and autonomous motivation which is defined as the extent to which people feel they have gone into treatment of their own free will and without external pressure. A team of researchers from the University of Toronto and McGill University in Montreal studied 74 people being treated for depression who each received 16 sessions of interpersonal therapy. Their study found that overall both the therapeutic alliance and autonomous motivation predicted remission from depression. However, for those patients whose depression was highly-recurrent autonomous motivation had no effect at all in whether they got better.
McBride, Carolina ... [et al] - Autonomous and controlled motivation and interpersonal therapy for depression: Moderating role of recurrent depression British Journal of Clinical Psychology Volume 49, Number 4, November 2010, 529-545