2,100
Views
153
CrossRef citations to date
0
Altmetric
Original Articles

A meta-analytic examination of client–therapist perspectives of the working alliance

, &
Pages 629-642 | Received 30 Dec 2005, Published online: 17 Oct 2007

References

  • Agnew-Davies , R. , Stiles , W. B. , Hardy , G. E. , Barkham , M. and Shapiro , D. A. 1998 . Alliance structure assessed by the Agnew Relationship Measure . British Journal of Clinical Psychology , 37 : 155 – 172 .
  • *Al-Darmaki , F. and Kivlighan , D. M. Jr . 1993 . Congruence in client–counselor expectations for relationship and the working alliance . Journal of Counseling Psychology , 40 : 379 – 384 .
  • Alexander , L. B. and Luborsky , L. 1989 . “ The Penn Helping Alliance scales ” . In The psychotherapeutic process: A research handbook , Edited by: Greenberg , L. S. and Pinsof , W. M. 325 – 366 . New York : Guilford Press .
  • *Bachelor , A. 1991 . Comparison and relationship to outcome of diverse dimensions of the helping alliance as seen by client and therapist . Psychotherapy , 28 : 534 – 549 .
  • *Bachelor , A. and Salame , R. 2000 . Participants’ perceptions of dimensions of the therapeutic alliance over the course of therapy . Journal of Psychotherapy Practice and Research , 9 : 39 – 53 .
  • *Bale , R. , Catty , J. , Watt , H. , Greenwood , N. and Burns , T. 2006 . Measures of the therapeutic relationship in severe psychotic illness: A comparison of two scales . International Journal of Social Psychiatry , 52 : 256 – 266 .
  • *Barber , J. P. , Luborsky , L. , Crits-Christoph , P. , Thase , M. E. , Weiss , R. , Frank , A. , Onken , L. and Gallop , R. 1999 . Therapeutic alliance as a predictor of outcome in treatment of cocaine dependence . Psychotherapy Research , 9 : 54 – 73 .
  • *Bikos , L. H. and Uruk , A. C. 2005 . Counseling outcome as a function of counselor nationality for American expatriate clients . International Journal for the Advancement of Counselling , 4 : 523 – 539 .
  • Bordin , E. S. 1979 . The generalizability of the psychoanalytic concept of the working alliance . Psychotherapy: Theory, Research and Practice , 16 : 252 – 260 .
  • *Brossart , D. F. , Patton , M. J. , Wilson , V. L. , Kivlighan , D. M. and Multon , K. D. 1998 . A time series model of the working alliance: A key process in short-term psychoanalytic counseling . Psychotherapy , 35 : 197 – 205 .
  • *Busseri , M. A. and Tyler , J. D. 2003 . Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form . Psychological Assessment , 15 : 193 – 197 .
  • *Busseri , M. A. and Tyler , J. D. 2004 . Client–therapist agreement on target problems, working alliance, and counseling outcome . Psychotherapy Research , 14 : 77 – 88 .
  • *Calsyn , R. J. , Klinkenberg , W. D. , Morse , G. A. and Lemming , M. R. 2006 . Predictors of the working alliance in assertive community treatment . Community Mental Health Journal , 42 : 161 – 175 .
  • *Casey , L. M. , Oei , T. P. S. and Newcombe , P. A. 2005 . Looking beyond the negatives: A time period analysis of positive cognitions, negative cognitions, and working alliance in cognitive-behavior therapy for panic disorder . Psychotherapy Research , 15 : 55 – 68 .
  • *Cecero , J. J. , Fenton , L. R. , Nich , C. , Frankforter , T. L. and Carroll , K. M. 2001 . Focus on therapeutic alliance: The psychometric properties of six measures across three treatments . Psychotherapy , 38 : 1 – 11 .
  • Christensen , A. , Margolin , G. and Sullaway , M. 1992 . Interparental agreement on child behavior problems . Psychological Assessment , 4 : 419 – 425 .
  • Cohen , J. 1992 . A power primer . Psychological Bulletin , 112 : 155 – 159 .
  • *Connors , G. J. , Carroll , K. M. , DiClemente , C. C. , Longabaugh , R. and Donovan , D. M. 1997 . The therapeutic alliance and its relationship to alcoholism treatment participation and outcome . Journal of Consulting and Clinical Psychology , 65 : 588 – 598 .
  • Constantino , M. J. , Castonguay , L. G. and Schut , A. J. 2002 . “ The working alliance: A flagship for the “scientist-practitioner” model in psychotherapy ” . In Counseling based on process research: Applying what we know , Edited by: Tryon , G. S. 81 – 131 . Boston : Allyn & Bacon .
  • *Couture , S. M. , Roberts , M. A. , Penn , D. L. , Cather , C. , Otto , M. W. and Goff , D. 2006 . Do baseline client characteristics predict the therapeutic alliance in the treatment of schizophrenia? . Journal of Nervous and Mental Disease , 194 : 10 – 14 .
  • Cummings , A. L. , Hallberg , E. T. , Slemon , A. and Martin , J. 1992 . Participants’ memories for therapeutic events and ratings of session effectiveness . Journal of Cognitive Psychotherapy , 6 : 113 – 124 .
  • *Cummings , A. L. , Martin , J. , Hallberg , E. T. and Slemon , A. 1992 . Memory for therapeutic events, session effectiveness, and working alliance in short-term counseling . Journal of Counseling Psychology , 39 : 306 – 312 .
  • *Davis , L. W. and Lysaker , P. H. 2004 . Neurocognitive correlates of therapeutic alliance in schizophrenia . Journal of Nervous and Mental Disease , 192 : 508 – 510 .
  • Dunkle , J. H. and Friedlander , M. L. 1996 . Contribution of therapist experience and personal characteristics to the working alliance . Journal of Counseling Psychology , 43 : 456 – 460 .
  • *Fenton , L. R. , Cecero , J. J. , Nich , C. , Frankforter , T. L. and Carroll , K. M. 2001 . The predictive validity of six working alliance instruments . Journal of Psychotherapy Practice and Research , 10 : 262 – 268 .
  • Field , A. P. 2005a . Discovering statistics using SPSS , 2nd ed , 66 – 69 . Thousand Oaks , CA : Sage .
  • Field , A. P. 2005b . Is the meta-analysis of correlation coefficients accurate when population correlations vary? . Psychological Methods , 10 : 444 – 467 .
  • *Fitzpatrick , M. R. , Iwakabe , S. and Stalikas , A. 2005 . Perspective divergence in the working alliance . Psychotherapy Research , 15 : 69 – 79 .
  • *Gallop , R. , Kennedy , S. H. and Stern , S. D. 1994 . Therapeutic alliance on an inpatient unit for eating disorders . International Journal of Eating Disorders , 16 : 405 – 410 .
  • Gaston , L. 1991 . Reliability and criterion-related validity of the California Psychotherapy Alliance Scales–Patient version . Psychological Assessment , 3 : 68 – 74 .
  • Gaston , L. , Thompson , L. , Gallager , D. , Cournoyer , L. G. and Gagnon , R. 1998 . Alliance, technique, and their interactions in predicting outcome of behavioral, cognitive, and brief dynamic therapy . Psychotherapy Research , 8 : 190 – 209 .
  • *Gaudiano , B. A. and Miller , I. W. 2006 . Patients’ expectancies, the alliance in pharmacotherapy, and treatment outcomes in bipolar disorder . Journal of Consulting and Clinical Psychology , 74 : 671 – 676 .
  • *Gehrs , M. and Goering , P. 1994 . The relationship between the working alliance and rehabilitation outcomes of schizophrenia . Psychosocial Rehabilitation Journal , 18 ( 2 ) : 43 – 54 .
  • Gelso , C. J. and Carter , J. A. 1985 . The relationship in counseling and psychotherapy: Components, consequences, and theoretical antecedents . The Counseling Psychologist , 13 : 155 – 243 .
  • Glass , G. V. 1976 . Primary, secondary and meta-analysis of research . Educational Researcher , 5 : 3 – 8 .
  • *Gunderson , J. G. , Najavits , L. M. , Leonhard , C. , Sullivan , C. N. and Sabo , A. N. 1997 . Ontogeny of the therapeutic alliance in borderline patients . Psychotherapy Research , 7 : 301 – 309 .
  • Hanson , W. E. , Curry , K. T. and Bandalos , D. L. 2002 . Reliability generalization of Working Alliance Inventory scale scores . Educational and Psychological Measurement , 62 : 659 – 673 .
  • Hatcher , R. L. 1999 . Therapists’ views of treatment alliance and collaboration in therapy . Psychotherapy Research , 9 : 405 – 423 .
  • Hatcher , R. L. and Barends , A. W. 1996 . Patients’ view of the alliance in psychotherapy: Exploratory factor analysis of three alliance measures . Journal of Consulting and Clinical Psychology , 64 : 1326 – 1336 .
  • *Hatcher , R. L. , Barends , A. , Hansell , J. and Gutfreund , M. J. 1995 . Patients’ and therapists’ shared and unique views of the therapeutic alliance: An investigation using confirmatory factor analysis in a nested design . Journal of Consulting and Clinical Psychology , 63 : 636 – 643 .
  • Hatcher , R. L. and Gillaspy , J. A. 2006 . Development and validation of a revised short version of the Working Alliance Inventory . Psychotherapy Research , 16 : 12 – 25 .
  • Hausner , R. S. 2000 . The therapeutic and working alliances . Journal of the American Psychoanalytic Association , 48 : 155 – 187 .
  • Hedges , L. V. and Vevea , J. L. 1998 . Fixed- and random-effects models in meta-analysis . Psychological Methods , 3 : 486 – 504 .
  • Hentschel , U. 2005 . Therapeutic alliance: The best synthesizer of social influences on the therapeutic situation? Or links to other constructs, determinants of its effectiveness, and its role for research in psychotherapy in general . Psychotherapy Research , 15 : 9 – 23 .
  • *Hersoug , A. G. , Hoglend , P. , Monsen , J. T. and Havik , O. E. 2001 . Quality of working alliance in psychotherapy: Therapist variables and patient/therapist similarity as predictors . Journal of Psychotherapy Practice and Research , 10 : 206 – 216 .
  • *Hersoug , A. G. , Monsen , J. T. , Havik , O. E. and Hoglend , P. 2002 . Quality of early working alliance in psychotherapy: Diagnoses, relationship and intrapsychic variables as predictors . Psychotherapy and Psychosomatics , 71 : 18 – 27 .
  • Hilsenroth , M. J. , Peters , E. J. and Ackerman , S. J. 2004 . The development of therapeutic alliance during psychological assessment: Patient and therapist perspectives across treatment . Journal of Personality Assessment , 83 : 332 – 344 .
  • Horvath , A. O. (1991, June). What do we know about the alliance and what do we still have to find out? Paper presented at the annual meeting of the Society for Psychotherapy Research , Lyon , France .
  • Horvath , A. O. and Bedi , R. P. 2002 . “ The alliance ” . In Psychotherapy relationships that work: Therapist contributions and responsiveness to patients , Edited by: Norcross , J. C. 37 – 69 . New York : Oxford University Press .
  • *Horvath , A. O. and Greenberg , L. S. 1989a . Development and validation of the Working Alliance Inventory . Journal of Counseling Psychology , 36 : 223 – 233 .
  • Horvath , A. O. and Greenberg , L. S. 1989b . “ The development of the Working Alliance Inventory ” . In The psychotherapeutic process: A research handbook , Edited by: Greenberg , L. S. and Pinsof , W. M. 529 – 556 . New York : Guilford Press .
  • Horvath , A. O. and Symonds , D. 1991 . Relationship between working alliance and outcome in psychotherapy: A meta-analysis . Journal of Counseling Psychology , 38 : 139 – 149 .
  • Hunter , J. E. and Schmidt , F. L. 2004 . Methods of meta-analysis: Correcting error and bias in research findings , 2nd ed , Thousand Oaks , CA : Sage .
  • Joyce , A. S. and Piper , W. E. 1998 . Expectancy, the therapeutic alliance, and treatment outcome in short-term individual psychotherapy . Journal of Psychotherapy Practice and Research , 7 : 236 – 248 .
  • Kivlighan , D. M. and Arthur , E. G. 2000 . Convergence in client and counselor recall of important session events . Journal of Counseling Psychology , 47 : 79 – 84 .
  • *Kivlighan , D. M. and Shaughnessy , P. 1995 . Analysis of the development of the working alliance using hierarchical linear modeling . Journal of Counseling Psychology , 42 : 338 – 349 .
  • *Kokotovic , A. M. and Tracey , T. J. 1990 . Working alliance in the early phase of counseling . Journal of Counseling Psychology , 37 : 16 – 21 .
  • Lingiardi , V. , Filippucci , L. and Baiocco , R. 2005 . Therapeutic alliance evaluation in personality disorders psychotherapy . Psychotherapy Research , 15 : 45 – 53 .
  • *Long , J. R. 2001 . Goal agreement and early therapeutic change . Psychotherapy , 38 : 219 – 232 .
  • *Luborsky , L. , Barber , J. P. , Siqueland , L. , Johnson , S. , Najavits , L. M. , Frank , A. and Daley , D. 1996 . The revised Helping Alliance Questionnaire (HAq-II): Psychometric properties . Journal of Psychotherapy Practice and Research , 5 : 260 – 271 .
  • Luborsky , L. and Crits-Christoph , P. 1990 . Understanding transference: The core conflictual relationship theme method , New York : Basic Books .
  • *Lunnen , K. M. and Ogles , B. M. 1998 . A multiperspective, multivariable evaluation of reliable change . Journal of Consulting and Clinical Psychology , 66 : 400 – 410 .
  • *Mallinckrodt , B. 1991 . Clients’ representations of childhood emotional bonds with parents, social support, and formation of the working alliance . Journal of Counseling Psychology , 38 : 401 – 409 .
  • *Mallinckrodt , B. 1993 . Session impact, working alliance, and treatment outcome in brief counseling . Journal of Counseling Psychology , 40 : 25 – 32 .
  • *Mallinckrodt , B. and Nelson , M. L. 1991 . Counselor training level and the formation of the psychotherapeutic working alliance . Journal of Counseling Psychology , 38 : 133 – 138 .
  • Marmar , C. R. , Gaston , L. , Gallagher , D. and Thompson , L. W. 1989 . Alliance and outcome in late-life depression . Journal of Nervous and Mental Disease , 177 : 464 – 472 .
  • Marmar , C. R. , Horowitz , M. J. , Weiss , D. S. and Marziali , E. 1989 . “ The development of the Therapeutic Alliance Rating System ” . In The psychotherapeutic process: A research handbook , Edited by: Greenberg , L. S. and Pinsof , W. M. 367 – 390 . New York : Guilford Press .
  • Martin , D. J. , Garske , J. P. and Davis , M. K. 2000 . Relation of the therapeutic alliance with outcome and other variables . Journal of Consulting and Clinical Psychology , 68 : 438 – 450 .
  • Meichenbaum , D. H. 1995 . “ Cognitive-behavioral therapy in historical perspective ” . In Comprehensive textbook of psychotherapy: Theory and practice , Edited by: Bongar , B. and Beutler , L. E. 140 – 158 . Oxford , , England : Oxford University Press .
  • *Meier , P. and Donmall , M. C. 2006 . Differences in client and therapist views of the working alliance in drug treatment . Journal of Substance Use , 11 : 73 – 80 .
  • *Meier , P. S. , Donmall , M. C. , Barrowclough , C. , McElduff , P. and Heller , R. F. 2005 . Predicting the early therapeutic alliance in the treatment of drug misuse . Addiction , 100 : 500 – 511 .
  • *Meier , P. , Donmall , M. C. , McElduff , P. , Barrowclough , C. and Heller , R. F. 2006 . The role of the early therapeutic alliance in predicting drug treatment dropout . Drug and Alcohol Dependence , 83 : 57 – 64 .
  • *Mollersen , S. , Sexton , H. C. and Holte , A. 2005 . Ethnic variations in the initial phase of mental health treatment: A study of Sami and non-Sami clients and therapists in northern Norway . Scandinavian Journal of Psychology , 46 : 447 – 457 .
  • Morgan , M. (2003) . The doctor-patient relationship . In G. Scambler Sociology as applied to medicine ( 5th ed ., pp. 49 – 65 ). Retrieved January 31, 2007, from http://www.fleshandbones.com/readingroom/pdf/583.pdf
  • *Neale , M. S. and Rosenheck , R. A. 1995 . Therapeutic alliance and outcome in a VA intensive case management program . Psychiatric Services , 46 : 719 – 721 .
  • Ogrodniczuk , J. S. , Piper , W. E. , Joyce , A. S. and McCallum , M. 2000 . Different perspectives of the therapeutic alliance and therapist technique in 2 forms of dynamically oriented psychotherapy . Canadian Journal of Psychiatry , 45 : 452 – 458 .
  • Paivio , S. C. and Bahr , L. B. 1998 . Interpersonal problems, working alliance, and outcome in short-term experiential therapy . Psychotherapy Research , 8 : 392 – 406 .
  • *Patton , M. J. , Kivlighan , D. M. and Multon , K. D. 1997 . The Missouri Psychoanalytic Counseling Research Project: Relation of changes in counseling process to client outcomes . Journal of Counseling Psychology , 44 : 189 – 208 .
  • *Petry , N. M. and Bickel , W. K. 1999 . Therapeutic alliance and psychiatric severity as predictors of completion of treatment for opioid dependence . Psychiatric Services , 50 : 219 – 227 .
  • *Puschner , B. , Bauer , S. , Horowitz , L. M. and Kordy , H. 2005 . The relationship between interpersonal problems and the helping alliance . Journal of Clinical Psychology , 61 : 415 – 429 .
  • Raue , P. J. , Castonguay , L. G. and Goldfried , M. R. 1993 . The working alliance: A comparison of two therapies . Psychotherapy Research , 3 : 197 – 207 .
  • Raue , P. J. , Putterman , J. T. , Goldfried , M. R. and Wolitzky , D. L. 1995 . Effect of rater orientation on the evaluation of the therapeutic alliance . Psychotherapy Research , 5 : 337 – 342 .
  • Reis , B. F. and Brown , L. G. 1999 . Reducing psychotherapy dropouts: Maximizing perspective convergence in the psychotherapy dyad . Psychotherapy , 36 : 123 – 136 .
  • Reynolds , C. R. and Kamphaus , R. W. 1992 . Behavior assessment system for children (BASC) , Circle Pines , MN : American Guidance Services .
  • Rosenthal , R. and Rosnow , R. L. 1991 . Essentials of behavioral research: Methods and data analysis , 2nd ed , New York : McGraw-Hill .
  • *Samstag , L. W. , Batchelder , S. T. , Muran , J. C. , Safran , J. D. and Winston , A. 1998 . Early identification of treatment failures in short-term psychotherapy: An assessment of therapeutic alliance and interpersonal behavior . Journal of Psychotherapy Practice and Research , 7 : 126 – 143 .
  • *Sauer , E. M. , Lopez , F. G. and Gormley , B. 2003 . Respective contributions of therapist and client adult attachment orientations to the development of the early working alliance: A preliminary growth modeling study . Psychotherapy Research , 13 : 371 – 382 .
  • Schmidt , F. L. and Le , H. 2004 . Software for the Hunter-Schmidt meta-analysis methods , Iowa City : University of Iowa, Department of Management & Organization .
  • *Schönberger , M. , Humle , F. and Teasdale , T. W. 2006 . The development of the therapeutic working alliance, patients’ awareness and their compliance during the process of brain injury rehabilitation . Brain Injury , 20 : 445 – 454 .
  • *Sexton , H. , Littauer , H. , Sexton , A. and Tommeras , E. 2005 . Building an alliance: Early therapy process and the client-therapist connection . Psychotherapy Research , 15 : 103 – 116 .
  • *Solomon , P. , Draine , J. and Delaney , M. A. 1995 . The working alliance and consumer case management . The Journal of Mental Health Administration , 22 : 126 – 134 .
  • Stewart , M. , & Roter , D. (1989) . Communicating with medical patients . London : Sage .
  • *Stiles , W. B. , Agnew-Davis , R. , Barkham , M. , Culverwell , A. , Goldfried , M. R. Halstead , J. 2002 . Convergent validity of the Agnew Relationship Measure and the Working Alliance Inventory . Psychological Assessment , 14 : 200 – 220 .
  • Stiles , W. B. , Agnew-Davis , R. , Hardy , G. E. , Barkham , M. and Shapiro , D. A. 1998 . Relations of the alliance with psychotherapy outcome: Findings in the Second Sheffield Psychotherapy Project . Journal of Consulting and Clinical Psychology , 66 : 791 – 802 .
  • Suh , C. S. and Strupp , H. H. 1989 . “ The Vanderbilt Process Measures: The Psychotherapy Process Scale (VPPS) and the Negative Indicators Scale (VNIS) ” . In The psychotherapeutic process: A research handbook , Edited by: Greenberg , L. S. and Pinsof , W. M. 285 – 323 . New York : Guilford Press .
  • *Tichenor , V. and Hill , C. E. 1989 . A comparison of six measures of the working alliance . Psychotherapy: Research and Practice , 26 : 195 – 199 .
  • Tracey , T. J. and Kokotovic , A. M. 1989 . Factor structure of the Working Alliance Inventory . Psychological Assessment , 1 : 207 – 210 .
  • *Tryon , G. S. and Kane , A. S. 1990 . The helping alliance and premature termination . Counselling Psychology Quarterly , 3 : 233 – 238 .
  • *Tryon , G. S. and Kane , A. S. 1993 . Relationship of working alliance to mutual and unilateral termination . Journal of Counseling Psychology , 40 : 33 – 36 .
  • *Tryon , G. S. and Kane , A. S. 1995 . Client involvement, working alliance, and type of therapy termination . Psychotherapy Research , 5 : 189 – 198 .
  • *Wei , M. and Heppner , P. P. 2005 . Counselor and client predictors of the initial working alliance: A replication and extension to Taiwanese client-counselor dyads . The Counseling Psychologist , 33 : 51 – 71 .
  • Zuroff , D. C. , Blatt , S. J. , Sotsky , S. M. , Krupnick , J. L. , Martin , D. J. , Sanislow , C. A. and Simmens , S. 2000 . Relation of therapeutic alliance and perfectionism to outcome in brief outpatient treatment for depression . Journal of Consulting and Clinical Psychology , 68 : 114 – 124 .

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.