Process and outcome in university counseling: the role of epistemic trust and working alliance.

Abstract

University counseling services are increasingly recognized as effective interventions for promoting students' psychological well-being, yet the psychological mechanisms underlying their effectiveness are still poorly understood. The present study examined the role of epistemic stances (epistemic trust, mistrust, and credulity) and therapeutic alliance in predicting changes in psychological distress among students undergoing a brief psychodynamic counseling intervention. The sample included 93 university students who participated in a brief psychodynamic counseling intervention consisting of four sessions and a 3-month follow-up. Data were analyzed using hierarchical linear mixed-effects models. Psychological distress was assessed using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at pre-treatment (T1), post-intervention (T2), and follow-up (T3). Epistemic stances were measured with the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) at T1, and therapeutic alliance was assessed at T2 with the Working Alliance Inventory - Short Form Revised (WAI-SR). Psychological distress significantly decreased from pretreatment to post-intervention and remained stable at follow-up. Higher baseline epistemic trust predicted lower levels of distress, whereas higher epistemic mistrust and credulity were associated with poorer outcomes. A stronger therapeutic alliance was associated with lower distress levels. Moreover, the therapeutic alliance moderated the relationship between epistemic mistrust and psychological distress, such that higher alliance was associated with lower distress. Findings suggest that both epistemic stances and the therapeutic alliance contribute to counseling effectiveness. A strong alliance may partially buffer the negative impact of epistemic mistrust, highlighting the importance of fostering a mentalizing environment in brief counseling interventions.