Therapeutic alliance: Its place as a process and outcome variable in dynamic psychotherapy research.

Abstract

Conceptual unclarity has surrounded psychotherapy research efforts to define and measure the therapeutic alliance. A precisely defined conception of the therapeutic alliance is offered that focuses on the patient's active collaboration in the tasks appropriate to the treatment process. The therapeutic alliance is thus distinguished from patient characteristics and attitudes as well as from therapist contributions to the formation of the alliance. The importance of the therapeutic alliance as a change measure in process research is underscored, and its place as a primary indicator of outcome is developed.Finally, the special relevance of the therapeutic alliance to the investigation of the therapeutic change process with borderline patients is outlined.

Moving ahead: Five essential elements for working effectively with girls

“…Consistent with the relational model, research on counseling has demonstrated that stronger alliances contribute to better therapeutic outcomes (Frieswyk, Allen, Colson, & Coyne, 1986;Horvath & Symonds, 1991;Stiles, Agnew-Davies, Hardy, Barkham, & Shapiro, 1998). Despite this, recent studies suggested that little emphasis is placed on helping correctional staff develop and practice the interpersonal skills needed to establish trusting and respectful helping alliances (Reddington & Wright-Kreisel, 2003;Taxman, 2002).…”

Adolescent and Parent Alliance and Treatment Outcome in Multidimensional Family Therapy.

“…The revised version includes only the 24 items appearing on the patient contribution (i.e., "To what extent did the patient acknowledge that he had a problem which the therapist could help him with") and therapist-patient interaction (i.e., "To what extent did the therapist and patient agree on the goals and tasks for the session") subscales. Items from the therapist contribution subscale were eliminated to differentiate between therapist techniques and the alliance itself (Frieswyk et al, 1986). For the purpose of this study, the total alliance score was used.…”

Discovering a relationship: adolescents' insights into the counselling relationship in a secondary school setting

“…Gel so and Carter ( 1985) describe the third component of their model, the working alliance, as collaborative, a characteristic that is consistent with this investigation and other significant literature written on the subject (Frieswyk, et al, 1986, Gelso & Carter, 1985, Horvath & Luborsky, 1993, Sexton & Whiston, 1994. Sexton and Whiston also suggest that from a social constructivist perspective the working alliance might be "a measure of the degree of agreement concerning the coconstruction of the relationship" (p. 63) and therefore, the "desired outcome of the process of coconstruction" (p. 63).…”