Two studies explored how counselor and client agreement on the therapy alliance, at the beginning of treatment, influenced early session evaluations and symptom change. Unlike prior studies that operationalized alliance convergence as either a profile similarity correlation or a difference score, the present study used polynomial regression and response surface analysis to examine agreement. Study 1 explored the impact of working alliance congruence on session depth and smoothness at the 3rd session of treatment with 36 client-counselor dyads. Results revealed that session smoothness was greater when clients' and therapists' perceptions of the working alliance were in agreement and high compared with when they were in agreement and low. In addition, clients rated sessions less smooth when their ratings of the alliance were lower than their therapists' ratings of the alliance, and they rated sessions as more smooth when their ratings of the alliance were higher than their therapists' ratings of the alliance. The authors did not find a significant relationship with session depth. In Study 2, the authors explored the impact of working alliance congruence, at the 3rd session of therapy, on symptom change for 63 client-counselor dyads. Results revealed that as the therapist and client have more positive agreement on the perceived alliance at the beginning of the treatment, there is greater symptom change. The authors also found that the consequences of alliance disagreement are the same regardless of who rated the alliance higher than the other. Implications and recommendations for future research are discussed.

In this article, we review the history and definition of countertransference, as well as empirical research on countertransference, its management, and the relation of both with psychotherapy outcome. Three meta-analyses are presented, as well as studies that illustrate findings from the meta-analyses. The first meta-analysis indicated that countertransference reactions are related inversely and modestly to psychotherapy outcomes (r = −.16, p = .02, 95% CI [−.30, −.03], d = −0.33, k = 14 studies, N = 973). A second meta-analysis supported the notion that countertransference management factors attenuate countertransference reactions (r = −.27, p = .001, 95% CI [−.43, −.10], d = −0.55, k = 13 studies, N = 1,065). The final meta-analysis revealed that successful countertransference management is related to better therapy outcomes (r = .39, p < .001, 95% CI [.17, .60], d = 0.84, k = 9 studies, N = 392 participants). In all meta-analyses, there was significant heterogeneity across studies. We conclude by summarizing the limitations of the research base and highlighting the therapeutic practices predicated on research.

D. Yalom's (1995) hypothesis that group climate mediates the relationship between leadership and outcome was tested. Group leaders (N = 43) recorded intentions, and adolescent group members (N = 233) rated climate after 8 semistructured group sessions. Members also rated satisfaction at termination. Leader intentions comprised 4 dimensions: therapeutic work, safe environment, interpersonal, and group structure. Changing group climates did mediate between these intentions and member outcome. Therapeutic work was negatively related and safe environment was positively related to an increasingly active and engaged climate, which was related to treatment benefit. Group structure and possibly interpersonal intentions were related to a climate decreasing in conflict and distance, which was related to a positive leader relationship. The importance of leaders focusing on group process rather than individual change is highlighted.For Yalom (1995), the group leader's primary responsibility is the creation of a therapeutic group climate. "If it is the group members who, in their interaction, set in motion the many therapeutic factors, then it is the group therapist's task to create a culture maximally conducive to effective group interaction" (Yalom, pp. 109-110). Yalom's writings suggest that the group members have a direct influence on member outcome whereas the group leader's influence is indirect, acting through the creation of a therapeutic group climate, denned as a series of interactional dimensions (MacKenzie, 1983). Group climate should mediate the relationship between group leader activity and group member outcome.Viewing group climate as a mediator provides a framework for summarizing the group leadership and group climate literatures. Baron and Kenny (1986) defined a mediator as a variable that explains the relationship between a

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Immediacy was examined in a 17-session case of brief therapy with a bright, articulate, inner-city, African American female client seeing an interpersonally oriented, White, male therapist. The main types of therapist immediacy were reinforcing the client for in-session behavior, inviting the client to collaborate, inquiring about client reactions to therapy, and reminding the client that it was okay to disagree with him. An in-depth qualitative examination of the seven most extensive/salient immediacy events revealed that therapist immediacy enabled the therapist and client to negotiate the relationship, helped the client express her immediate feelings to the therapist, helped the client open up to deeper exploration of concerns, and provided the client with a corrective relational experience. Implications for practice and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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A short-term psychoanalytic counseling model was used to identify process dimensions and client outcomes. Six counselors saw 16 clients over the course of 2 semesters. Clients responded to measures at pre-and posttest and after each session, and counselors filled out measures following each session. Sessions were audio-and videotaped and viewed by trained raters. P-technique factor analysis identified 4 dimensions: Psychoanalytic Technique, Working Alliance, Client Resistance, and Client Transference. Results of hierarchical linear modeling indicated that counselor use of psychoanalytic technique and the working alliance increased steadily across the sessions, whereas client resistance steadily decreased. The alliance dimension also changed in a quadratic fashion. The process dimensions also influenced each other and were related to better client outcomes. Implications are discussed and suggestions for future research are provided.