Therapeutic alliance

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The therapeutic alliance or working alliance in psychotherapy has been defined as the collaborative and affective bond between therapist and patient. Additionally, the therapeutic alliance has been defined as a personal bond between therapist and client in which goals for therapy and and steps to achieve treatment goals are established.

Contents 1 See also 2 References & Bibliography 3 Key texts 3.1 Books 3.2 Papers 4 Additional material 4.1 Books 4.2 Papers 5 Further references 6 External links

[edit] See also

• Psychotherapeutic processes
• Psychotherapeutic transference

[edit] References & Bibliography

[edit] Key texts

[edit] Books

• Bender, D. S. (2005). Therapeutic Alliance. Washington, DC: American Psychiatric Publishing, Inc.

[edit] Papers

• Bachelor, A. (1991) Comparison and relationship to outcome of diverse dimensions of the helping alliance as seen by client and therapist. Psychotherapy Theory Research and Practic. 28 534-539.
• Bachelor, A. (1995) clients’ perception of the therapeutic alliance: a qualitative analysis. Journal of Counselling Psychology. 42 3 323-337.
• Bambling M., & King R., (2001) Therapeutic alliance and clinical practice. Psychotherapy in Australia. 8 1 38-47
• Bordin, E. (1976) The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory Research and Practice. 16 252-260.
• Bordin, E. S. (1994) Theory and research on the therapeutic working alliance: New directions. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory research, and practice, New York: Wiley.
• Eaton, T. I, Abeles, N., & Guttreund, M. (1988) Therapeutic alliance and outcome: Impact of treatment length and pretreatment symptomology Psychotherapy Research and Practice. 25 536-542.
• Foreman, S., & Marmar, R. C. (1985) Therapist actions that address initially poor therapeutic alliances in psychotherapy. American Journal of Psychiatry 4 922-926.
• Gaston, L. (1990) The concept of the alliance and its role in psychotherapy: theoretical and empirical considerations, Psychotherapy 27, 143-153.
• Gaston, L. (1991) Reliability and criterion-related validity of the california psychotherapy alliance scales—patient version. Psychological Assessment. 3, 68-74.
• Gaston, L., Marmar, C R., Gallager, D., & Thompson, L. W (1988) Relation of patient pretreatment characteristics to the therapeutic alliance in diverse psychotherapies. Journal of Consulting and Clinical Psychology. 56 483-489.
• Gaston, L., Marmar, C. R., Thompson, L. W & Gallager, D. (1991) Alliance prediction of outcome beyond in-treatment symptomatic change as psychotherapy progresses. Psychotherapy Research. 1 104-1 12.
• Hartley, D. E., & Strupp, H. H. (1983) The therapeutic alliance: Its relationship to outcome in brief psychotherapy. In I Masling (Ed.), Empirical studies in analytic theories (pp. 1-37). Hillside, NJ: Erlbaum.
• Hatcher, R., Barends, A., Hansell, J., & Gutfreund, M. (1995) Patient’s and therapists’ shared and unique views of the therapeutic alliance: an investigation using confirmatory factor analysis in a nested design. Journal of Consulting and Clinical Psychology. 63 636-643.
• Hatcher, R., & Barends, A. (1996) Patient’s view of the alliance in psychotherapy: exploratory factor analysis of three alliance measures. Journal of Consulting and Clinical Psychology. 64 1326-1336
• Henry W R. & Strupp, H. (1994) The therapeutic alliance as an interpersonal process. In A. O. Horvath & L. S. Greenberg (Eds.) The working alliance: Theory, research and practice, New York: Wiley.
• Horvath, A. O. (1981) An exploratory study of the working alliance: Its measurement and relationship to outcome Unpublished doctoral dissertation, University of British Columbia. Quoted in: Horvath, A. O. (1994). Empirical research on the alliance. Horvath & Greenberg (Eds.), The working alliance theory research and practice. New York: Wiley
• Horvath, A. O. (1982) Working Alliance Inventory (Revised). Instructional Psychology Research Group, 82 (1). Simon Fraser University Burnaby, British Columbia, Canada.
• Horvath, A. O. (1991) What do we know about the alliance and what do we still have to find out? Paper presented at the annual meeting of the Society for Psychotherapy Research, Lyon, France.
• Horvath, A. O. (1994) Empirical research on the alliance. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance theory research and practice. New York: Wiley.
• Kivlighan, D., Angelone, E., & Swafford, K. (1991) Live supervision in individual psychotherapy: effects on therapists’ intention use and client’s evaluation of session effect and working alliance. Professional Psychology: Research and Practice. 22 6 489-495.
• Kivlighan, D., & Shaughnessy, P. (1995) Analysis of the development of the working alliance using hierarchical linear modeling. Journal of Counselling Psychology. 42 3 338-349.
• Kivilghan, D. M., Jr., & Schmitz, P. (1992). Counselor technical activity in cases with improving working alliances and continuing-poor working alliances. Journal of Counseling Psychology. 39 32-38.
• Kokotovic, A., & Tracey, I. (1990) Working alliance in the early phase of counseling. Journal of Counseling Psychology. 37 16-21.
• Krupnick, I. (1990, June) The relationship of therapeutic alliance and outcome in interpersonal psychotherapy and cognitive behavioral therapy. Paper presented at the annual meeting of the Society for Psychotherapy Research, Wintergreen, VA.
• Krupnick, J., Stotsky, S., Simmens, S., & Moyer, J. (1996) The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the MIMH treatment of depression collaborative research program. Journal of Consulting and Clinical Psychology. 64 3 532-539.
• Luborsky, L. (1976) Helping alliances in psychotherapy. In I L. Cleghhorn (Ed.), Successful psychotherapy, New York: Brunner/Mazel, 92 - 116.
• Luborsky, L., & Auerbach, A. (1985) The therapeutic relationship in psychodynamic psychotherapy: The research evidence and its meaning for practice. In R. Hales & A. Frances (Eds.), Psychiatry update annual review (pp. 550 - 561). Washington, VC: American Psychiatric Association.
• Mallinckrodt, B., & Nelson, M. (1991) Counselor training level and the formation of the therapeutic working alliance. Journal of Counseling Psychology, 38 14-19.
• Mallinckrodt, B., Gantt, G., & Coble, H. (1995) Attachment patterns in the therapy relationship: development of the client attachment to therapist scale. Journal of Counselling Psychology. 42 307-317.
• Mallinckrodt, B. (1996) Change in working alliance, social support, and psychological symptoms in brief therapy. Journal of Counselling Psychology. 43 4 448-455.
• Marmar, C., Gaston L., Gallagher, D, & Thompson l., (1989) Alliance and outcome in late life depression. Journal of Nervous and Mental disease. 177 464-472.
• Marmar, C. R., Horowitz, M. J., Weiss, D. S., & Marziali, E. (1986) The development of the therapeutic alliance rating system. In L. S. Greenberg & W. M. Pinsof (Eds.), The psychotherapeutic process: A research handbook. New York: Guilford Press, 367 - 390.
• Marmar, C., Weiss, D. S., & Gaston, L. (1989) Toward the validation of the California Therapeutic Alliance Rating System. Psychological Assessment: Journal of Consulting and Clinical Psychology. 1 46 - 52.
• Martin D, J., Garske J, P., & Davis, M, K. (2000) Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology. 68 3 438-50.
• Morgan, R., Luborsky, L., Crits-Cristoph, P., Curtis, H., & Solomon, J. (1982) Predicting the outcomes of psychotherapy by the Penn Helping Alliance Rating Method. Archives of General Psychiatry. 39 397 - 401.
• Pinsof, W. (1994) Integrative systems perspective on the therapeutic alliance: theoretical, research and clinical implications. In A. Horvath & Greenberg (ed), The working alliance: theory research and practice. New York: Wiley, 173-189.
• Piper, W. E., Azim, H. F. A., Joyce, A. S., & McCallum, M. (1991 [a]) Transference interpretations, therapeutic alliance and outcome in short-term individual therapy. Archival of General Psychiatry. 48 946-953.
• Piper, W. E., Azim, H. F. A., Joyce, A. S., MacCallum, M., Nixon, G. W. H., & Segal, P. S. (1991 [b]) Quality of object relations vs. interpersonal functioning as a predictor of therapeutic alliance and psychotherapy outcome. Journal of Nervous and Mental Disease. 17 9 432-438.
• Raue, P. & Goldfried, M. (1997) The therapeutic alliance in psychodynamic – interpersonally and cognitive - behavioral therapy. Journal of Consulting and Clinical Psychology. 65 4 582-587.
• Raue, P., Castonguay, L., & Goldfried, M. (1993) The working alliance: a comparison of two therapists. Psychotherapy Research. 3 197-207.
• Raue, P., & Godfried, M. (1994) The therapeutic alliance in cognitive-behavior therapy. In A. Horvath & L. Greenberg (Eds) The working alliance: theory, research and practice. New York: Wiley.
• Reandeau, S., & Wampold, B. (1991) Relationship of power and involvement to working alliance: a multiple case sequential analysis of brief therapy. Journal of Counselling Psychology. 38 107-114
• Rector, N., Zuroff, D., & Segal, Z. (1999) Cognitive change and the therapeutic alliance: the role of technical and nontechnical factors in cognitive therapy. Psychotherapy. 36 320-328.
• Safran, J., Crocker, P., McMain, S., & Munay, P. (1990).Therapeutic alliance rupture as a therapy event for empirical investigation. Psychotherapy. 27 154164.
• Safran, J., Muran, J., Wallner, S., & Samstag, L. (1992, June) A comparison of therapeutic alliance rupture resolution and nonresolution events. Paper presented at the annual meeting of the Society for Psychotherapy Research, Berkeley, CA.
• Safran, J., Muran, J., & Samstag, L. (1994) Resolving therapeutic ruptures: a task analytic investigation. In A. O. Horvath & L. S. Greenberg (Eds.), The Working Alliance: Theory,Rresearch, and Practice. New York: Wiley.
• Safran J., & Muran J. (1996) The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology. 64 3 447-58.
• Safran J., & Muran J. (2000) Resolving therapeutic alliance ruptures: diversity and integration. Journal of Clinical Psychology. 56 2 233-43.
• Satterfield, W., & Lyddon, W. (1995) Client attachment and perception of the therapeutic alliance with counselor trainees. Journal of Counseling Psychology. 42 187-189.
• Stiles, W., Agnew-Davies, R., Hardy, G., Barkham, M., & Shapiro, D. (1998) Relations of the alliance with psychotherapy outcome: findings in the second sheffield psychotherapy project. Journal of Consulting and Clinical Psychology. 66 791-802.
• Weerasekera, P., Linder, B., Greenberg, L., & Watson, J. (2001) The working alliance in client-centered and process-experiential therapy of depression. Psychotherapy Research. 11 2 221-233.

[edit] Additional material

[edit] Books

[edit] Papers

• Google Scholar
• Allen, J., Szollos, S., & Williams, E. (1986). The penn helping alliance scales. In Greenberg & Pinsof (Eds). The psychotherapeutic process: A research handbook. 325-3666. New York: Guilford.
• Dozier, R., Hicks, M., Cornille, T., & Peterson, G. (1998) The effect of Tomm’s therapeutic questioning styles on therapeutic alliance: a clinical analogue study. Family Process. 37 2 189-200.
• Efstation, J., Patton, M., & Kardash, C. (1990) Measuring the working alliance in counsellor supervision. Journal of Counselling Psychology. 37 322-329.
• Fenton, L., Cecero, J., Nich, C., Frankforter, T., & Carroll, K. (2001) Perspective is everything: the predictive validity of six working alliance instruments. Journal of Psychotherapy Practice and Research. 10 262-268.
• Marziali, E. (I984 [b]) Three viewpoints on the therapeutic alliance scales: Similarities, differences and associations with psychotherapy outcome. Journal of Nervous and Mental Disease. 172 417-423.
• The Penn Helping Alliance Scales (1993) In L., S. Greenberg & W., M. Pinsof (Eds.), The Psychotherapeutic Process A Research Handbook. New York: Guilford Press, 325-366.
• Tichenor, V., & Hill, C. (1989) A comparison of six measures of working alliance. Psychotherapy: Research and Practice. 26 195-199

[edit] Further references

Abend, S. M. (1996). The problem of therapeutic alliance: Journal of Clinical Psychoanalysis Vol 5(2) 1996, 213-240.

• Abend, S. M. (2000). The problem of therapeutic alliance. Madison, CT: International Universities Press, Inc.
• Ackerman, S. J., & Hilsenroth, M. J. (2001). A review of therapist characteristics and techniques negatively impacting the therapeutic alliance: Psychotherapy: Theory, Research, Practice, Training Vol 38(2) Sum 2001, 171-185.
• Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist charcteristics and techniques positively impacting the therapeutic alliance: Clinical Psychology Review Vol 23(1) Feb 2003, 1-33.
• Ackerman, S. J., Hilsenroth, M. J., Baity, M. R., & Blagys, M. D. (2000). Interaction of therapeutic process and alliance during psychological assessment: Journal of Personality Assessment Vol 75(1) Aug 2000, 82-109.
• Adler, G. (1992). The myth of the therapeutic alliance with borderline patients revisited. Madison, CT: International Universities Press, Inc.
• Alkalay, L. (2006). Profiling adolescent substance abusers by therapeutic alliance. Dissertation Abstracts International: Section B: The Sciences and Engineering.
• Allen, J. G., Newsom, G. E., Gabbard, G. O., & Coyne, L. (1984). Scales to assess the therapeutic alliance from a psychoanalytic perspective: Bulletin of the Menninger Clinic Vol 48(5) Sep 1984, 383-400.
• Ambresin, G., de Roten, Y., Drapeau, M., & Despland, J.-N. (2007). Early change in maladaptive defence style and development of the therapeutic alliance: Clinical Psychology & Psychotherapy Vol 14(2) Mar-Apr 2007, 89-95.
• Anderson, T., Ogles, B. M., & Weis, A. (1999). Creative use of interpersonal skills in building a therapeutic alliance: Journal of Constructivist Psychology Vol 12(4) Oct-Dec 1999, 313-330.
• Arnkoff, D. B. (1995). Two examples of strains in the therapeutic alliance in an integrative cognitive therapy: In Session: Psychotherapy in Practice Vol 1(1) Spr 1995, 33-46.
• Arnkoff, D. B. (2000). Two examples of strains in the therapeutic alliance in an integrative cognitive therapy: Journal of Clinical Psychology Vol 56(2) Feb 2000, 187-200.
• Bachelor, A. (1995). Clients' perception of the therapeutic alliance: A qualitative analysis: Journal of Counseling Psychology Vol 42(3) Jul 1995, 323-337.
• Bachelor, A., & Salame, R. (2000). Participants' perceptions of dimensions of the therapeutic alliance over the course of therapy: Journal of Psychotherapy Practice & Research Vol 9(1) Win 2000, 39-53.
• Baillargeon, P., Leduc, A., & Cote, R. (2003). Experimental models of processes for resolving ruptures in the therapeutic alliance: Revue de Psychoeducation Vol 32(2) 2003, 373-392.
• Baillargeon, P., Pinsof, W. M., & Leduc, A. (2005). Systemic model of therapeutic alliance: European Review of Applied Psychology/Revue Europeenne de Psychologie Appliquee Vol 55(3) Sep 2005, 137-143.
• Baillargeon, P., Pinsof, W. M., & Leduc, A. (2005). Therapeutic alliance: The creation and the progression of the attachment: European Review of Applied Psychology/Revue Europeenne de Psychologie Appliquee Vol 55(4) Dec 2005, 225-234.
• Bak, G. B. (2004). Therapeutic alliance rupture types in time-limited psychotherapy with a focus on the discrepancy between patients' and therapists' perception of the ruptures. Dissertation Abstracts International: Section B: The Sciences and Engineering.
• Barber, J. P., Luborsky, L., Gallop, R., Crits-Christoph, P., Frank, A., Weiss, R. D., et al. (2001). Therapeutic alliance as a predictor of outcome and retention in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study: Journal of Consulting and Clinical Psychology Vol 69(1) Feb 2001, 119-124.
• Barlow, S. M. (2005). The relationship of adolescent attachment to parents and peers with therapeutic alliance. Dissertation Abstracts International: Section B: The Sciences and Engineering.
• Barofsky, I. (1978). Compliance, adherence and the therapeutic alliance: Steps in the development of self-care: Social Science & Medicine Vol 12(5) Sep 1978, 369-376.
• Battistini, A. (2005). Therapeutic alliance and the psychoanalytic paradigm: Rivista di Psicoanalisi Vol 51(3) Aug-Sep 2005, 721-737.
• Baumann, B. D., Hilsenroth, M. J., Ackerman, S. J., Baity, M. R., Smith, C. L., Smith, S. R., et al. (2001). The Capacity for Dynamic Process Scale: An examination of reliability, validity, and relation to therapeutic alliance: Psychotherapy Research Vol 11(3) Sep 2001, 275-294.
• Beauford, J. E., McNiel, D. E., & Binder, R. L. (1997). Utility of the initial therapeutic alliance in evaluating psychiatric patients' risk of violence: American Journal of Psychiatry Vol 154(9) Sep 1997, 1272-1276.
• Beck, M. (2006). Three perspectives on the therapeutic alliance in family therapy: A qualitative-quantitative study. Dissertation Abstracts International: Section B: The Sciences and Engineering.
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• Bedi, R. P., Davis, M. D., & Williams, M. (2005). Critical Incidents in the Formation of the Therapeutic Alliance from the Client's Perspective: Psychotherapy: Theory, Research, Practice, Training Vol 42(3) Fal 2005, 311-323.
• Bedregal, L. E., Paris, M., Jr., Anez, L. M., Shahar, G., & Davidson, L. (2006). Preliminary Evaluation of the Validity and Reliability of the Spanish Version of the Therapeutic Alliance with Clinician (TAC) Questionnaire: Social Indicators Research Vol 78(1) Aug 2006, 19-32.
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• Bennett, D., & Parry, G. (2004). Maintaining the therapeutic alliance: Resolving alliance-threatening interactions related to the transference. Mahwah, NJ: Lawrence Erlbaum Associates Publishers.
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• Black, S., Hardy, G., Turpin, G., & Parry, G. (2005). Self-reported attachment styles and therapeutic orientation of therapists and their relationship with reported general alliance quality and problems in therapy: Psychology and Psychotherapy: Theory, Research and Practice Vol 78(3) Sep 2005, 363-377.
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• Bond, M., Banon, E., & Grenier, M. (1998). Differential effects of interventions on the therapeutic alliance with patients with personality disorders: Journal of Psychotherapy Practice & Research Vol 7(4) Fal 1998, 301-318.
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• Constantino, M. J., Manber, R., Ong, J., Kuo, T. F., Huang, J. S., & Arnow, B. A. (2007). Patient expectations and therapeutic alliance as predictors of outcome in group cognitive-behavioral therapy for insomnia: Behavioral Sleep Medicine Vol 5(3) 2007, 210-228.
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• Couture, S. M., Roberts, D. L., Penn, D. L., Cather, C., Otto, M. W., & Goff, D. (2006). Do baseline client characteristics predict the therapeutic alliance in the treatment of schizophrenia? : Journal of Nervous and Mental Disease Vol 194(1) Jan 2006, 10-14.
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