Table 1.

Examples of SOMA Indicators and Illustrative Quotes by Alliance Dimension

Dimension	Sample Behavioral Indicators	Hypothetical Quotes
ENGAGEMENT
Patient	Patient asks the provider to explain the treatment recommendations	“So you think more exercise will help? So how often should I be exercising?”
Provider	Provider encourages the patient to take an active role in the consultation	“I’m really curious to hear your thoughts about what would be most helpful for you right now.”
TRUST
Patient	Patient expresses confidence in the provider’s knowledge/expertise or ability to help	“You’ve always helped me in the past, and you’re the one with the medical degree and experience, so I’ll do whatever you think I should try next.”
Provider	Provider offers reassurance or normalizes the patient’s reactions or emotions	“It is really hard to live with constant pain, and I’m aware that many people with your condition often feel frustrated or even hopeless at times.”
CONCORDANCE	Provider and patient agree on the etiology of the patient’s health/medical concerns	Patient: “I think I’m short of breath because I’ve been smoking for so long.” Provider: “Yeah, I think you are probably right about that.”