Patient-Therapist Perspective of the Working Alliance in Psychotherapy
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This study aimed to examine perceptions of the working alliance in a sample of Spanish patients and therapists. The alliance was measured after the third and tenth psychotherapy sessions using patient and therapist versions of the Spanish adaptation of the Working Alliance Inventory (WAI). After both sessions, correlations between the patients’ and therapists’ ratings, both of total alliance and of the various dimensions of the alliance, were moderate at best. Moreover, after the third psychotherapy session, patients’ scores for the total alliance and the Goal and Task subscales were significantly higher than the scores from their therapists in these dimensions. Following the tenth session, patient ratings exceeded those of their therapists only on the Task subscale. Finally, in contrast to the ratings of patients, therapists’ alliance ratings increased significantly between the third and tenth sessions of psychotherapy. Certain recommendations are presented to improve the study of patient and therapist perceptions of the working alliance and to increase the convergence between them with regard to this central treatment variable.
KeywordsWorking alliance Patient perspective Therapist perspective Patient-therapist convergence
Compliance with Ethical Standards
Conflict of Interest
All authors declared no conflicts of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent was obtained from all patients for being included in the study.
- 2.Stiles WB, Goldsmith JZ: The alliance over time. In: Muran JC, Barber JP, editors. The therapeutic alliance: an evidence-based guide to practice. New York NY, Guilford Press, 2010. pp. 44–62.Google Scholar
- 4.Horvath AO: An exploratory study of the working alliance: its measurement and relationship to therapy outcome (unpublished doctoral dissertation). Vancouver Canada, University of British Columbia, 1981.Google Scholar
- 5.Horvath AO, Greenberg LS: The development of the Working Alliance Inventory. In: Greenberg LS, Pinsof WM, editors. The psychotherapeutic process: a research handbook. New York NY, Guilford Press, 1986. pp. 529–556.Google Scholar
- 10.Andrade-González N, Fernández-Liria A: Spanish Adaptation of the Working Alliance Inventory (WAI): psychometric properties of the patient and therapist forms (WAI-P and WAI-T). Anales de Psicología 31:524–533, 2015.Google Scholar
- 11.American Psychiatric Association: Manual diagnóstico y estadístico de los trastornos mentales [Diagnostic and statistical manual of mental disorders] 4.ª ed. text rev. Barcelona Spain, Masson, 2002.Google Scholar
- 13.Bordin ES: Theory and research on the therapeutic working alliance: new directions. In: Horvath AO, Greenberg LS, editors. The working alliance: theory, research and practice. New York NY, John Wiley & Sons, 1994. pp. 13–37.Google Scholar
- 17.Horvath AO, Greenberg LS: Introduction. In: Horvath AO, Greenberg LS, editors. The working alliance: theory, research and practice. New York NY, John Wiley & Sons, 1994. pp. 1–9.Google Scholar
- 24.Safran JD, Muran JC: Negotiating the therapeutic alliance: a relational treatment guide. New York NY, Guilford Press, 2000.Google Scholar
- 27.Sharpless BA, Muran JC, Barber JP: Coda: recommendations for practice and training. In: Muran JC, Barber JP, editors. The therapeutic alliance: an evidence-based guide to practice. New York NY, Guilford Press, 2010. pp. 341–354.Google Scholar