The study uses 457 clients to investigate the impact of initial client factors on the development of therapeutic alliance. Data were collected longitudinally over the early portion of treatment. Cases included both individual and couple clients, allowing for examination of differences by case type. The study used the Working Alliance Inventory-Shortened Version (Tracey & Kokotovic, 1989) to measure therapeutic alliance. Initial factors considered included age, differentiation levels, prior stress, and depression. Couple clients showed differences from individual clients, and the variability prompted further investigation into relationship satisfaction and commitment as factors influencing the development of therapeutic alliance. Results highlight the increased complexity of developing an alliance with couples, and recommendations are provided for clinicians.

Therapeutic alliance research in couple therapy using multiple perspectives and longitudinal data has been sparse. This study used structural equation modelling to explore relationships between changes in alliance and in progress from clients' and therapists' perspective in a fairly large sample of couples (N 5 195) during the initial stage of therapy at an oncampus training clinic. Self-rated alliance was measured after sessions 2 through 4 with the Working Alliance Inventory. There was very little change in alliance over the early sessions of therapy, and changes in alliance did not always account for changes in relationship satisfaction. Husbands' perceptions of satisfaction and alliance seem to play an important role in the dynamics of the therapeutic process. Findings suggest a reciprocal relationship between perceptions of alliance and progress in therapy when combining perceptions of therapists and couple clients. Clinical implications and future research are discussed.

A sample of 168 couples were assessed at intake and over the first six sessions of treatment providing the opportunity to investigate not only the impact of client and common factors on initial levels of satisfaction, but also trajectories of change in satisfaction over time. The study used multi-level modelling to examine changes in relationship satisfaction for both partners, thus enabling the couple to be maintained as the unit of analysis. We first examined changes in satisfaction and, having discovered differences there, we then investigated the impact of client factors of differentiation and stress in explaining these differences in relationship satisfaction. Finally we explored the additional influence of the common factor, therapeutic alliance, while controlling for the client factors, on relationship satisfaction.

Research concerning therapeutic alliance and outcome is prevalent but relies heavily on data from individual treatment. In this article, the authors present data from cases in which an individual was seen and cases in which a couple was seen in order to investigate differences in therapeutic alliance and its trajectory depending on case type, therapist experience, and therapist sex. Participants included 96 couples and 52 individuals with 15 therapists from a large Midwestern training clinic for couple and family therapy. Data include the use of the Working Alliance Inventory-Shortened Version, and three-level models were estimated using hierarchical linear modeling. The results highlight differences in the trajectories of individual and couple clients' therapeutic alliance, including evidence for a curvilinear trend in work scores for individual clients but not couple clients. The results also highlight differences in the sources of variation for couple cases versus individual cases. There is clearly complexity in the building of alliance with clients in general, and even more so with couple clients.

No abstract