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The therapeutic alliance is critical in couple therapy. Recent research has explored what factors might contribute to its creation. This study looks at two such factors: client stage of change and symptom distress, and how the relationship between symptom distress and the alliance might be mediated by client stage of change. The sample for this study was composed of 181 couples attending therapy for relationship problems. Participants completed questionnaires at intake and following the fourth session. Significant relationships were found for males between the precontemplation stage and the alliance, and symptom distress. Females entered therapy at higher stages of change than males, although no variables were found to be associated with the therapeutic alliance for females. No mediation occurred for males or females. Implications for couple therapists are discussed.

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