The positive relation between the quality of the alliance and diverse outcomes for many different types of psychological therapies is confirmed in this meta-analysis. While the overall ES of r = .275 accounts for a relatively modest proportion of the total variance in treatment outcome, the magnitude of this correlation, along with therapist effects, is one of the strongest and most robust predictors of treatment success empirical research has been able to document (Wampold, 2001). The practice recommendations presented below are based on important studies of the alliance...
The Aim of this book is to provide an evidence-based approach to the therapeutic alliance - specifying practice and training guidelines from various psychotherapy orientations that can be supported by the research literature.
Chapters include: Stanley Messer and David Wolitzky - A psyhodyamic perspective Jeanne C Watson and Freda Kalogerapkos - The theraputic alliance in humanistic psychotherapy William E. Piper and John S. Ogrodniczuk- The therapeutic alliance in group psychotherapy
Practitioners should be aware that patients often have negative feelings about the psychotherapy or the therapeutic relationship that they are reluctant to broach for fear of the therapist's reactions. It is thus important for therapists to be attuned to subtle indications of ruptures in the relationship and to take the initiative in exploring what is transpiring in the relationship when they suspect that a rupture has occurred.
In short, each person's alliance matters, and alliances are not interchangeable. Each and every alliance exerts both direct and interactive effects on the course of treatment. Thus, clinicians should build and maintain strong alliances with each party and be aware of the ways in which, depending on the family's dynamics, the whole alliance is more than the sum of its parts.
The current meta-analysis of prospective studies of individual youth alliance-outcome associations yielded an effect that is quite comparable to results obtained in the adult literature (Martin et al., 2000). It is noteworthy that this is the first meta-analysis to use inclusion criteria that are highly similar to those used in adult meta-analyses. Specifically, the sample was restricted to studies of individual therapy that measured alliance prior to outcome. Although the establishment of temporal ordering is essential for causal inference, it is not sufficient. Nevertheless, these results strengthen the claim that the alliance is an important predictor of treatment outcome in child and adolescent therapy. Future studies need to account for the potential impact of treatment gains prior to alliance measurement, and for other process variables that could share predictive variance with the alliance.
(Excerpt courtesy Noreen Keenan via Penelope Norton)