Alliance in Individual Psychotherapy

Horvath, Adam O.; Re, A. C. Del; Flückiger, Christoph; Symonds, Dianne

doi:10.1093/acprof:oso/9780199737208.003.0002

Cited by 388 publications

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“…Horvath et al (2011) found a significant moderator in the alliance rater, where the variability between the client-rated alliance and the therapist-rated alliance was greater than expected by chance.…”

Section: Measures Of Alliancementioning

confidence: 75%

“…Trim and Fill analysis can also be difficult to interpret in the presence of significant heterogeneity (Peters, Sutton, Jones, Abrams, & Rushton, 2007; 41 Terrin, Schmid, Lau, & Olkin, 2003). This is of particular concern to the present study,given the heterogeneity found in past meta-analyses of the same topics (Elliot et al, 2011;Horvath et al, 2011; Kolden et al, 2011). As such, the trim and fill analysis is best thought of as a sensitivity analysis, providing possible hints about the presence, nature, and extent of publication bias.…”

mentioning

confidence: 73%

“…Horvath and colleagues (e.g., Horvath et al, 2011;Horvath & Bedi, 2002; Horvath & Symonds, 1991) and Martin et al have conducted meta-analyses examining the therapeutic alliance related to treatment outcome. These reviews, based on 24 to 190 studies, have concluded that alliance and outcome are moderately related (r = 0.21-0.275).…”

Section: Therapeutic Alliance and Outcomementioning

confidence: 99%

“…Horvath et al (2011) addressed differences between alliance measures in their final meta-analysis. The authors did not find any significant moderator effects between alliance measures.…”

Section: Measures Of Alliancementioning

confidence: 99%

“…given the heterogeneity found in past meta-analyses of the same topics (Elliot et al, 2011;Horvath et al, 2011; Kolden et al, 2011). As such, the trim and fill analysis is best thought of as a sensitivity analysis, providing possible hints about the presence, nature, and extent of publication bias.…”

mentioning

confidence: 96%

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A meta-analytic review of the relationships between the therapeutic alliance, empathy, and genuineness in individual adult psychotherapy.

Nienhuis

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ACKNOWLEDGEMENTSI would like to thank my co-chairs for their individual contributions and guidance.Dr. Jesse Owen, thank you for your help exploring the many nuances in the therapeutic relationship literature and helping me apply this work to psychotherapy practice. Our talks helped me see the different facets of the therapeutic relationship and how perception means so much in therapy. I also want to thank you for your insight during advanced practicum and for introducing me to short-term dynamic therapy, which I continue to use and teach to others.Dr. Jeff Valentine, thank you for your instruction in meta-analysis and guidance that brought this project to completion. You were there at the beginning, when I was still wrestling with translating ideas about therapy relationships into a study-able dissertation question. I really enjoyed our talks, over tea and coffee, as this project gained momentum. Thank you for all your help with the study methodology and showing me how to communicate it in a succinct, meaningful way.I would also like to thank Dr. Stephanie Budge and Dr. Mark Hilsenroth for their comments and assistance as committee members. Your calm and humorous personalities made an otherwise stressful life event so much more bearable. I never expected to laugh so much during my proposal defense. Special thanks to AC Del Re for his help in creating and providing personal assistance with R-based meta-analysis software.I want to express my utmost thanks to my wife Miriam for her patience, support, and kind words throughout the full grad school process. You were there before this iv whole process started and you've been strong through all the ups and downs that have come as a result. It's difficult to fully credit Miriam's contribution in such a short space. This dissertation explored the relationship between the therapeutic alliance and perceptions of therapist empathy and genuineness through a systematic review and metaanalysis. Alliance, empathy, and genuineness are each integral parts of the therapeutic relationship. Prior meta-analyses demonstrated that alliance, empathy, and genuineness each had a moderate relationship to therapy outcome. No previous analysis has explored how therapist empathy and genuineness contribute to the therapeutic alliance. Studies for this analysis were obtained through a multi-part search strategy. Out of 2,141 obtained abstracts, 46 studies contained enough data for inclusion in the meta-analysis. Thirty-six studies reported alliance/empathy relationships, six studies reported alliance/genuineness relationships, and four studies reported both. Random effects meta-analyses revealed that therapeutic alliance was related to perceptions of therapist empathy with a mean r(k = 40) = .51 (95% CI = 0.43-0.59). Therapeutic alliance was related to perceptions of therapist genuineness with a mean r(k = 10) = .53 (95% CI = 0.40-0.65). Tests of publication bias indicated a low likelihood of publication bias affecting the strength and direction of the results. Potential moderating variables w...

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Section: Measures Of Alliancementioning

confidence: 75%

mentioning

confidence: 73%

Section: Therapeutic Alliance and Outcomementioning

confidence: 99%

“…Horvath et al (2011) addressed differences between alliance measures in their final meta-analysis. The authors did not find any significant moderator effects between alliance measures.…”

Section: Measures Of Alliancementioning

confidence: 99%

mentioning

confidence: 96%

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A meta-analytic review of the relationships between the therapeutic alliance, empathy, and genuineness in individual adult psychotherapy.

Nienhuis

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Therapeutic/Working Alliance

Horvath

2015

The Encyclopedia of Clinical Psychology

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Therapeutic/working alliance refers to the strength of the collaborative dimensions of the therapist–client relationship. Historically rooted in psychodynamic theory, more recently it has evolved into a pan‐theoretical concept. Research evidence indicates a moderate but robust positive link between alliance and therapy outcome (effect size = .27). This link can be already detected in the early phases (sessions 3–5) of treatment. The alliance, or its management, may be linked to outcome directly (as a source of therapeutic effect) and/or indirectly (as a force that binds the client to the therapeutic strategies). Recent meta‐analyses suggest that the strength of the alliance–outcome relation varies across studies; therefore it is likely that the alliance plays different roles in different contexts. Emerging research indicates that therapists are the dominant force determining the alliance quality; some therapists achieve better alliances across a variety of clients, others are consistently less successful.

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Psychotherapy Integration for Counselling Psychology

LAMBERT,

NORCROSS

2015

Counselling Psychology ‐ a Textbook for Study and Practice

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Alliance in Individual Psychotherapy

Cited by 388 publications

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A meta-analytic review of the relationships between the therapeutic alliance, empathy, and genuineness in individual adult psychotherapy.

A meta-analytic review of the relationships between the therapeutic alliance, empathy, and genuineness in individual adult psychotherapy.

Therapeutic/Working Alliance

Psychotherapy Integration for Counselling Psychology

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