Group‐based processes as a framework for understanding the working alliance in therapy

Abstract

Objective The working alliance construct faces persistent issues with conceptualisation. We present a social identity analysis of working alliance. Here, we examine the links between alliance, the focal shared sense of “us” in social identification and identity leadership scholarship, and research on the role of “voice” (i.e., being provided with the opportunity to state one's own perspective to others) in enabling procedural justice. We hypothesised that working alliance would be predicted by group processes (i.e., social identification, identity leadership and procedural justice) and serve as an important mediator through which these processes enable desired therapeutic and organisational outcomes. Method An online experiment sampled participants recently in therapy for a diagnosed mental disorder and recently employed. Participants were randomly assigned to recall either a therapy session or work meeting in which they had received or not received voice. Results Social identification, identity leadership and procedural justice were found to account for approximately 70% of variance in working alliance. Working alliance, in turn, predicted positive affect, negative affect and satisfaction, in addition to mediating the relationship between group‐based processes and these outcomes. Conclusion These novel findings suggest that group‐based processes are useful for conceptualising the working alliance in therapy, by both enhancing theory and providing practical clinical strategies for facilitating alliance.

A social identity approach to facilitating therapy groups.

“…Although further empirical research examining the relationship and overlap between these concepts in group therapy settings is needed, evidence to date suggests (a) that social identification can give rise to greater perceptions of group cohesion and (b) that efforts to increase either within a group are likely to simultaneously increase the other. This is evidenced by prior research conducted in individual therapy settings (e.g., Cruwys et al, 2023; G. C. Lee et al, 2022) demonstrating that social identification and therapeutic alliance are strongly related, and that identity leadership positively predicts therapeutic alliance ratings.…”

“…The researchers found that the extent to which participants felt a strong sense of shared identification with their therapist positively predicted their ratings of the therapeutic alliance. Importantly, G. C. Lee et al (2022) also found that the extent to which participants perceived that their therapist engaged in identity leadership also positively predicted greater therapeutic alliance.…”

“…The researchers found that the extent to which participants felt a strong sense of shared identification with their therapist positively predicted their ratings of the therapeutic alliance. Importantly, G. C. Lee et al (2022) also found that the extent to which participants perceived that their therapist engaged in identity leadership also positively predicted greater therapeutic alliance. A recent study by Cruwys et al (2023) obtained similar findings: both social identification and identity leadership ratings positively predicted substantial variance in client ratings of the therapeutic alliance.…”

“…There is already some evidence that speaks to this in individual therapy. In a recent study, G. C. Lee et al (2022) recruited 251 individual therapy clients and asked them to recall their therapy experiences and rate the strength of their therapeutic alliance with their therapist. The researchers found that the extent to which participants felt a strong sense of shared identification with their therapist positively predicted their ratings of the therapeutic alliance.…”

“…There is already some evidence that speaks to this in individual therapy. In a recent study, G. C. Lee et al (2022) recruited 251 individual therapy clients and asked them to recall their therapy experiences and rate the strength of their therapeutic alliance with their therapist.…”