Aim of the study:
The present study attempted to see whether the use of supportive techniques and improving working alliance in the initial sessions of short-term supportive-expressive (SE) psychodynamic psychotherapy results in a change in the symptoms of patients with depressive disorder.

Subject or material and methods:
The research design was an experiential single case. Subjects included six women with major depression disorder who were selected by the purposive sampling method. Measures included working alliance inventory-12, quality of life scale, and Beck Depression Inventory II. Visual analysis with graphs, mean, standard deviation, and the Friedman test were used for data analysis.

Results:
The results indicated no significant increase or decrease in the severity of depression on the baseline (χ2 = 3.54, p = 0.14) and during evaluation sessions (χ2 = 0.85, p = 0.65), but participants showed significant improvement in quality of life after the sessions started (χ2 = 8.95, p = 0.01). The mean scores of all three working alliance components showed a slight increase over three sessions and the scores of the bond subscale showed a significant increase (χ2 = 11.56, p = 0.003).

Discussion:
It was clearly observed in this study that despite a slight increase in the severity of depression in at least four participants, the patients’ quality of life and working alliance, especially the bond component, improved during the initial sessions of psychotherapy.

Conclusions:
These findings may reflect the importance of the working alliance in the initial sessions, which can lead to a change in the patient’s mental experience of quality of life.