The Relationship of Client Stages of Change to Working Alliance and Outcome in Short-Term Counseling

Abstract

This study evaluated the relationship of J. O. Prochaska's (1984; J. O. Prochaska & C. C. DiClemente, 1992) transtheoretical model of change with the process and outcome of short‐term counseling in college help seekers. Participants completed measures of readiness to change, psychological symptoms, and working alliance. Clients in the precontemplation stage evaluated the working alliance less favorably and experienced less improvement regarding symptoms than clients in other stages. Counselor working alliance did not differ as a function of clients' stage of change.

Contributing Factors in the Therapeutic Alliance

“…Principe et al (2006) provided a possible answer reporting that another variable, client stage of change, was significantly related to the alliance. Other researchers have reported similar findings, suggesting that client readiness for Contributing Factors in the Therapeutic Alliance 203 change at the outset of therapy is a determining factor for subsequent higher ratings of the therapeutic alliance (Rochlen, Rude, & Baron, 2005;Taft et al, 2004). In fact, Connors et al (2000) found client stage of change was one of only two variables positively related to the alliance for outpatients, and the only variable positively related to the alliance among aftercare patients.…”

“…Finally, they noted decreasing scores on the precontemplation stage, in contrast to increasing scores on the other stages, represent an increasing readiness to change, implying a negative correlation with the other stages. Rochlen, Rude, and Baron (2005) found no difference between clients on these stages across any of their predictor or outcome variables, stating, "There may be little practical utility in distinguishing between the contemplation, maintenance, and action stages" (p. 60).…”

Stages of change and the working alliance in psychotherapy

“…This is one of the most commonly used methods (e.g., Derisley & Reynolds, 2000;Koraleski & Larson, 1997;Rochlen et al, 2005) and has been used in approximately 60% of previous studies on the stages and processes of change (Rosen, 2000). In this method, participants are assigned to one of the stages based on their highest subscale score.…”

“…Furthermore, studies have found that it is very challenging to form a working relationship with clients who are reluctant to begin working on their problems or who are ambivalent about the change process (Bachelor & Horvath, 1999;Hatcher & Barends, 1996). Building off of these previous findings, recent research has shown that the stages of change are significantly correlated with the working alliance, with individuals in the higher stages of change reporting stronger working alliances than those in the lower stages of change (Principe, 2005;Rochlen et al, 2005;Taft, Murphy, Musser, & Remington, 2004;Treasure et al, 1999).…”

“…The research generated from the TTM has not only provided practitioners with empirically validated suggestions for how to work best with different types of clients, but has also shown that clients' stage of change plays an important role in predicting therapeutic outcome (Franko, 1997;McConnaughy, Prochaska, Velicer, & DiClemente, 1984;Rochlen, Rude, & Baron, 2005;Treasure et al, 1999;Wolk & Devlin, 2001). Numerous studies have shown that clients entering psychotherapy in either the action or maintenance stages have better therapeutic outcomes than those in the precontemplation or contemplation stages (Scott & Wolfe, 2003;Treasure et al, 1999;Wolk & Devlin, 2001).…”