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Therapist factors and the therapeutic alliance

12 December 2003


A high-quality therapeutic alliance between a therapist and his or her client has been shown to be one of the best predictors of positive outcomes in therapy. An assessment tool designed to measure the therapeutic alliance between client and therapist is the Working Alliance Inventory (WAI; Horvath & Greenberg, 1989). A great amount of research has been conducted focusing on client characteristics and their effect on the WAl, but little in comparison has been done looking at the effect of therapist factors on the alliance. This study was conducted with 27 doctoral psychology fIrst year, second year, and internship level training clinicians and 104 clients with the hope of better understanding the amolmt of emphasis placed on the therapeutic alliance when training clinicians. The clinicians fIlled out a questionnaire on clinical experience, number of
weekly hours spent preparing for clients, supervisor's emphasis on the therapeutic alliance/relationship, the clinician's use of manualized treatments, and the training clinician's developing theoretical orientation. Therapist level of experience and number of weekly preparation hours were unrelated to the WAl. A negative correlation was found between a therapist's supervisor's emphasis on the therapeutic relationship and the client W Al. Significant and positive correlations were found between the use of manuals, the value placed on them, manual adherence and the client's rating on the goal scale of the W Al. A significant correlation was found between the therapist's theoretical
orientation, defined as either behavioral or not, and the client's rating on the W Al. The results indicated that the clients of more behaviorally oriented therapists rated the therapeutic alliance higher.


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