What works in psychotherapy?

My research is about mechanisms of change in psychotherapy, mainly about patient-therapist relationship quality and patients’ capacity for mentalization. Many psychotherapy researchers are preoccupied with finding the best treatment method, but the most common result of such studies is that different methods achieve roughly equal results. At the same time, there is a lot of room for improved effects, since on average only about half the patients in research trials show measurable improvement. To be able to improve psychotherapy I believe that it is necessary to study variables that do not differ among methods, but that may be important for outcome.

I am also interested in methods development to be better able to study cause-effect relationships even when experimental manipulation is not possible, and for studying differences between patients in which processes are most important for therapy outcome. Another area of interest is cultural differences in how psychological distress is experienced and interpreted, and what consequences this can have on the patient-therapist relationship and treatment effectiveness.


Falkenström, F., Kuria, M. W., Othieno, C. J., & Kumar, M. (2018). Working alliance predicts symptomatic improvement in public hospital delivered psychotherapy in Nairobi, Kenya. Journal of Consulting and Clinical Psychology. doi:10.1037/ccp0000363

Holmqvist Larsson, M., Falkenström, F., Andersson, G., & Holmqvist , R. (2018). The Alliance and Rupture Observation Scale (AROS): Development and validation of an alliance and rupture measure for repeated observations within psychotherapy sessions. Journal of Clinical Psychology. doi:10.1002/jclp.22704

Falkenström, F., Kumar, M., Zahid, A., Kuria, M., & Othieno, C. (2018). Factor analysis of the Clinical Outcomes in Routine Evaluation – Outcome Measures (CORE-OM) in a Kenyan sample. BMC Psychology, 6(1), 48. doi:10.1186/s40359-018-0260-1


Mattias Holmqvist Larsson, Fredrik Falkenström, Gerhard Andersson, Rolf Holmqvist

Alliance ruptures and repairs in psychotherapy in primary care

In Psychotherapy Research

Article in journal

Judy Wanjiru Mbuthia, Manasi Kumar, Fredrik Falkenström, Mary Wangari Kuria, Caleb Joseph Othieno

Attributions and private theories of mental illness among young adults seeking psychiatric treatment in Nairobi: an interpretive phenomenological analysis

In Child and Adolescent Psychiatry and Mental Health

Article in journal


Karin Lindqvist, Fredrik Falkenström, Rolf Sandell, Rolf Holmqvist, Annika Ekeblad, Agneta Thoren

Multilevel Exploratory Factor Analysis of the Feeling Word Checklist-24

In Assessment (Odessa, Fla.)

Article in journal