Contributing Factors in the Therapeutic Alliance

Abstract

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.

Parent–Worker Relationships in Home Visiting: Intersections of Parental Gender, Ethnicity, and Immigrant Status

“…In addition to gender differences in the quality of relationships with workers, some studies that examined working alliances in therapy settings have proposed the moderating role of gender or gender differences in the association between other parental characteristics and the working alliance. Porter and Ketring (2011) showed that male participants’ distress significantly decreased working alliance quality with their therapists, whereas this relationship was not significant among female participants. Another example is Knerr et al’s (2011) study, which found that among male participants, the development and maintenance of strong working alliances were more strongly influenced by their partners’ factors than by their own.…”

“…Demographic (e.g., age) and socioeconomic characteristics (e.g., education, income, and employment) are significant factors (Cho et al, 2017; Knerr et al, 2011; O’Brien et al, 2012). In addition, parents’ positive beliefs about their engagement and psychological characteristics (e.g., depression) can affect their relationships with workers in home visiting (Porter & Ketring, 2011; Stargel et al, 2020). Finally, parents’ relational factors are important, such as quality relationships with partners and living arrangement status (O’Brien et al, 2012).…”

“…This research gap is important to address given that father engagement is essential to ensure the success of home visiting (Bellamy et al, 2023). Some studies in the fields of individual, couple, or family therapy have shown that levels of working alliances differ by gender, and that gender also moderates the effects of other factors on the working alliance (Knerr et al, 2011; Porter & Ketring, 2011).…”

Replication of the learning alliance inventory to blended student populations

“…Bordin (1979) defines the therapeutic working alliance as including three features: an agreement on goals, an assignment of task or series of tasks and the development of bonds. Since the construct of a therapeutic working alliance was suggested by Bordin, investigations have been consistently published demonstrating sound construct validity in both the therapy and the educational change enterprises and establishing its presence and efficacy in these contexts (Ackerman & Hilsenroth, 2003; Duff & Bedi, 2010; Falkenström, Grastrom, & Holmqvist, 2013; Porter & Ketring, 2011; Siefert & Hilsenroth, 2014; Wampold, 2001).…”