Comparison and relationship to outcome of diverse dimensions of the helping alliance as seen by client and therapist

Abstract

This study explored the correspondence and respective contributions to improvement of subscales of three alliance measures (the Penn Helping Alliance Method, the Therapeutic Alliance Rating System, the Vanderbilt Psychotherapy Process Scale), focusing on perceptions of client and therapist. Participants involved 47 clients of a university consultation service seen for approximately 23 sessions and 23 therapists in training. Assessments of alliance variables were obtained at three phases of the helping process, whereas improvement was based on pre- and posttherapy difference scores on diverse measures of psychological status, adjustment, and target problems as rated by supervisors, clients, and therapists. Clients and therapists differed significantly in their perceptions of several alliance variables. Interscale correlations indicated a partial redundancy of all the positive toned therapist contributions including therapist exploratory activities. Findings support the convergent and discriminant validities of alliance dimensions. Results of multiple regression analyses support the predictive validity of the alliance. Predictors varied depending on source of perception of the alliance and evaluative perspective. Client perceptions yielded the stronger predictions and involved therapist-offered helpfulness, warmth and emotional involvement, and exploratory interventions.