A study of the working alliance in psychotherapy

Originally identified by Freud (1912, 1913), the therapeutic or working alliance between client and therapist has in the last decade been proposed as the common factor that could account for psychotherapeutic outcome regardless of the theoretical orientations and/or techniques employed by therapists. Psychotherapy researchers (Allen, Newsom, Gabbard, & Coyne, 1984; Hartley & Strupp, 1983; Horvath, 1981; Luborsky, 1976; Marziali, Marmar, & Krupnick, 1981) have developed various scales for measuring the alliance and have quite consistently demonstrated an alliance-outcome relationship. The Working Alliance Inventory (Horvath, 1981, 1982) is the first self-report instrument developed to measure the alliance construct. It is based on the theory proposed by Bordin (1975, 1979) that the alliance is the product of the synergistic combination of three highly related components -- goal mutuality, agreement regarding relevant tasks and responsibilities, and the development of personal bonds or attachments. In the present study, the Working Alliance Inventory was administered after each of the first five, the tenth, and the final sessions of 44 psychotherapy cases. It was found to be statistically significantly related to outcome by the third to fifth session on four of the six outcome measures employed. Another self-report measure, the Helping Alliance Questionnaire (Luborsky, McLellan, Woody, O'Brian, & Auerbach, 1985) was also administered at the third session, as well as measures of therapist empathy, expertness, attractiveness, and trustworthiness. The Helping Alliance Questionnaire, which is based on a clinically-derived definition of the alliance, was found to be statistically significantly related to outcome on all six of the measures employed. Speculations concerning the differential patterns of results with the two alliance measures are offered.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat