The role of the therapeutic alliance in psychotherapy.

Abstract

This is the first dedicated review of quantitative studies on Sigmund Freud's proposition that the poorer the psychological health, the more limited are the benefits from treatment. Since observer-rated scales for psychological health-sickness were developed in 1949, many studies have applied them, and the majority show significant prediction of outcomes of psychotherapy, with correlations between .2 and .35. This article reviews (a) the main methods of measurement, (b) the record of predictive success, (c) validity studies, (d) the relation to psychiatric diagnosis, (e) prediction in forms of treatment other than psychotherapy, and (e) theories of why psychological health predicts outcomes of psychotherapy.

Client Satisfaction and Outcome Comparisons of Online and Face-to-Face Counselling Methods

“…Horvath and Luborsky (1993) identify openness, respect and a collaborative bond as essential components of the therapeutic alliance. The first three questions concerning client comfort, the establishing of a plan and the client's perception of the counsellor's skill and expertise are intended to address the building of this alliance.…”

Moving ahead: Five essential elements for working effectively with girls

“…The therapeutic, or helping, alliance is the collaborative relationship that develops within a helping relation ship. According to Horvath and Luborsky (1993), a strong helping alliance enhances a client's capacity for positive psychological change. Although implied by the "what works" responsivity principle, the helping alliance, as an essential element for working effectively with girls, is most closely aligned with the "gender-responsive" literature.…”

Early Therapeutic Alliance as a Predictor of Treatment Outcome for Adolescent Cannabis Users in Outpatient Treatment

“…1 Individual and meta-analytic studies on the therapeutic alliance with adults have demonstrated that: a) it is established by the third or fourth session; b) early alliance is a better predictor of outcome than later alliance; c) it predicts outcome equally well regardless of theoretical orientations; d) patient, therapist, and observer alliance ratings are all predictive of outcome, with patient's point of view being especially predictive; and e) the correlations between these different perspectives are low. 2,3 There is also evidence that alliance impacts treatment retention. 4 Most alliance research has focused on adult individual psychotherapy, with very few studies focused on children and adolescents.…”