Therapeutic/Working Alliance

Abstract

Therapeutic/working alliance refers to the strength of the collaborative dimensions of the therapist–client relationship. Historically rooted in psychodynamic theory, more recently it has evolved into a pan‐theoretical concept. Research evidence indicates a moderate but robust positive link between alliance and therapy outcome (effect size = .27). This link can be already detected in the early phases (sessions 3–5) of treatment. The alliance, or its management, may be linked to outcome directly (as a source of therapeutic effect) and/or indirectly (as a force that binds the client to the therapeutic strategies). Recent meta‐analyses suggest that the strength of the alliance–outcome relation varies across studies; therefore it is likely that the alliance plays different roles in different contexts. Emerging research indicates that therapists are the dominant force determining the alliance quality; some therapists achieve better alliances across a variety of clients, others are consistently less successful.