This study examined sources of therapist effects in a sample of 25 therapists who saw 1,141 clients at a university counseling center. Clients completed the Outcome Questionnaire-45 (OQ-45) at each session. Therapists' facilitative interpersonal skills (FIS) were assessed with a performance task that measures therapists' interpersonal skills by rating therapist responses to video simulations of challenging client-therapist interactions. Therapists completed the Social Skills Inventory (SSI) and therapist demographic data (e.g., age, theoretical orientation) were available. To test for the presence of therapist effects and to examine the source(s) of these effects, data were analyzed with multilevel modeling. Of demographic predictor variables, only age accounted for therapist effects. The analysis with age, FIS, and SSI as predictors indicated that only FIS accounted for variance in outcomes suggesting that a portion of the variance in outcome between therapists is due to their ability to handle interpersonally challenging encounters with clients.

Therapists' interpersonal characteristics may influence client progress in therapy.

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Because research suggests that counseling expectations are malleable and that alliance ratings predict clinical outcomes, the relationship between this pretreatment client characteristic (expectations) and the quality of the alliance early in treatment deserves further attention. This study examined the relationships between 57 clients' pretreatment role expectations and 3rd-session client-rated alliance in a naturalistic setting. Prior to intake, clients completed the Expectations About Counseling-Brief Form (H. E. A. Tinsley, 1982), and clients completed the Working Alliance Inventory-Short Form Revised (R. L. Hatcher & J. A. Gillaspy, 2006) following the 3rd therapy session. Results indicate that clients' expectations for personal commitment predicted the task, bond, and goal dimensions of the alliance. Expectations for facilitative conditions and counselor expertise did not predict clients' perceptions of the alliance. Clinical implications and research directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Studies that employ multidimensional attachment measures to explore the impact of attachment style on psychotherapy process and outcome are virtually absent in the literature. Further, the role of the working (therapeutic) alliance as a mediator of the influence of attachment on treatment outcome has not been formally investigated. In order to address these gaps in the research, archival data from 66 psychotherapy clients treated at a university graduate program training clinic were used to examine the influence of three adult attachment dimensions (Comfort with Closeness, Comfort Depending on Others, and Rejection Anxiety) on the therapeutic alliance and outcome, as well as to assess whether the alliance mediates the relationship between attachment and therapy outcome. Both Comfort with Closeness and Comfort Depending on Others were significantly related to alliance and outcome, whereas Rejection Anxiety was not significantly related to either variable. Alliance was a significant partial mediator of the effect of Comfort with Closeness on outcome. The results suggest that multidimensional measures of attachment capture important influences on alliance and psychotherapy and that Comfort with Closeness promotes successful outcome by virtue of its influence on alliance.