The Alliance as a Discursive Achievement: A Conversation Analytical Perspective

  • Adam O. Horvath
  • Peter Muntigl
Part of the The Language of Mental Health book series (TLMH)


We show how the working relationship between therapist and client can be realized, maintained, and, if necessary, repaired discursively. Therapists come to each session with intentions rooted in theoretical premises and clinical experiences, but the clinical praxis, the unfolding of therapy itself, involves interactive and sequential responsiveness. Our project involves the use of the conceptual and methodological resources of Conversational Analysis to systematically explicate how different aspects of the relationship between therapist and client and among the clients themselves are managed discursively. As an example of how such approach can serve to better understand the development of the alliance and the achievement of therapeutic change, we provide an analysis of a family therapy consultation by Dr. S. Minuchin and two clients. Methodological and clinical implications of our work are provided.


  1. Antaki, C. (2008). Formulations in psychotherapy. In A. Peräkylä, C. Antaki, S. Vehviläinen, & I. Leudar (Eds.), Conversation analysis and psychotherapy (pp. 26–42). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  2. Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. Scholar
  3. Buchholtz, M. B., & Kächele, H. (2017). From turn-by-turn to larger chunks of talk: An exploratory study in psychotherapeutic micro-processes using conversation analysis. Research in Psychotherapy: Psychopathology, Process and Outcome, 20, 161–178.Google Scholar
  4. Buttny, R. (1993). Social accountability in communication. London: Sage.Google Scholar
  5. Drew, P. (1998). Complaints about transgressions and misconduct. Research on Language and Social Interaction, 31, 295–325.CrossRefGoogle Scholar
  6. Geller, S. M., & Greenberg, L. S. (2002). Therapeutic presence: Therapists’ experience of presence in the psychotherapy encounter. Person-Centered and Experiential Psychotherapies, 1(1–2), 71–86.CrossRefGoogle Scholar
  7. Goffman, E. (1981). Footing. In E. Goffman (Ed.), Forms of talk (pp. 124–159). Oxford: Basil Blackwell.Google Scholar
  8. Greenson, R. R. (1990). The working alliance and the transference neurosis. In A. H. Esman & A. H. Esman (Eds.), Essential papers on transference (pp. 150–171). New York, NY: New York University Press.Google Scholar
  9. Hepburn, A., & Bolden, G. (2013). The conversation analytic approach to transcription. In J. Sidnell & T. Stivers (Eds.), The handbook of conversation analysis (pp. 57–76). Chichester, UK: Wiley-Blackwell.Google Scholar
  10. Hepburn, A., & Potter, J. (2007). Crying receipts: Time, empathy, and institutional practice. Research on Language and Social Interaction, 40, 89–116.CrossRefGoogle Scholar
  11. Heritage, J. (2004). Conversation analysis and institutional talk: Analyzing data. In D. Silverman (Ed.), Qualitative research: Theory, method and practice (2nd ed., pp. 222–245). London: Sage.Google Scholar
  12. Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology, 61, 561–573.CrossRefGoogle Scholar
  13. Minuchin, S. (1974). Families & family therapy. Cambridge, MA: Harvard University Press.Google Scholar
  14. Muntigl, P., & Hadic Zabala, L. (2008). Expandable answers: How clients get prompted to say more during psychotherapy. Research on Language and Social Interaction, 41(2), 187–226.CrossRefGoogle Scholar
  15. Muntigl, P., & Horvath, A. O. (2014a). The therapeutic relationship in action: How therapists and clients co-manage relational disaffiliation. Psychotherapy Research.
  16. Muntigl, P., & Horvath, A. O. (2014b). “I can see some sadness in your eyes”: When experiential therapists notice a client’s affectual display. Research on Language and Social Interaction, 47(2), 89–108.CrossRefGoogle Scholar
  17. Muntigl, P., & Horvath, A. O. (2016). A conversation analytic study of building and repairing the alliance in family therapy. Journal of Family Therapy, 38(1), 102–119. Scholar
  18. Muntigl, P., Knight, N., Horvath, A. O., & Watkins, A. (2012). Client affectual stance and therapist-client affiliation: A view from grammar and social interaction. Research in Psychotherapy: Psychopathology, Process and Outcome, 15(2), 117–130.Google Scholar
  19. Peräkylä, A. (2008). Conversation analysis and psychotherapy/edited by Anssi Peräkylä … [et al.] (A. Peräkylä, Trans.). Cambridge: Cambridge University Press.Google Scholar
  20. Pomerantz, A. (1980). Telling my side: “Limited access” as a “fishing” device. Sociological Inquiry, 50, 186–198.CrossRefGoogle Scholar
  21. Pomerantz, A. (1984). Agreeing and disagreeing with assessment: Some features of preferred/dispreferred turn shapes. In J. Atkinson & J. Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp. 57–101). Cambridge: Cambridge University Press.Google Scholar
  22. Ribeiro, A. P., Ribeiro, E., Loura, J., Gonçalves, M. M., Stiles, W. B., Horvath, A. O., et al. (2014). Therapeutic collaboration and resistance: Describing the nature and quality of the therapeutic relationship within ambivalence events using the Therapeutic Collaboration Coding System. Psychotherapy Research, 24(3), 346–359. Scholar
  23. Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting and Clinical Psychology, 22, 95–103.CrossRefGoogle Scholar
  24. Schegloff, E. A. (2007). Sequence organization in interaction: A primer in conversation analysis. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  25. Schegloff, E. A., Jefferson, G., & Sacks, H. (1977). The preference for self-correction in the organization of repair in conversation. Language, 53, 361–382.CrossRefGoogle Scholar
  26. Sidnell, J. (2006). Coordinating gesture, talk, and gaze in reenactments. Research on Language and Social Interaction, 39(4), 377–409.CrossRefGoogle Scholar
  27. Sidnell, J., & Stivers, T. (Eds.). (2013). The handbook of conversation analysis. Oxford, UK: Wiley-Blackwell.Google Scholar
  28. Stiles, W. B. (1988). Psychotherapy process-outcome relations may be misleading. Psychotherapy: Theory, Research, Practice and Training, 25, 27–35.CrossRefGoogle Scholar
  29. Stiles, W. B. (2011). Coming to terms. Psychotherapy Research, 21(4), 367–384.CrossRefGoogle Scholar
  30. Stiles, W. B., Honos-Web, L., & Surko, M. (1998). Responsiveness in psychotherapy. Clinical Psychology: Science and Practice, 5, 439–458.Google Scholar
  31. Stiles, W. B., & Horvath, A. O. (2017). Appropriate responsiveness as a contribution to therapist effects. In L. G. Castonguay & C. E. Hill (Eds.), Therapist effects: Toward understanding how and why some therapists are better than others (pp. 71–84). Washington, DC: APA Books.Google Scholar
  32. Stivers, T., Mondada, L., & Steensig, J. (2011). Knowledge, morality and affiliation in social interaction. In T. Stivers, L. Mondada, & J. Steensig (Eds.), The morality of knowledge in conversation (pp. 3–24). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  33. Stivers, T., & Rossano, F. (2010). Mobilizing response. Research on Language and Social Interaction, 43, 3–31.CrossRefGoogle Scholar
  34. Symonds, B. D., & Horvath, A. O. (2004). Optimizing the alliance in couple therapy. Family Process, 43(4), 443–455.CrossRefGoogle Scholar
  35. White, M. (2007). Maps of narrative practice. New York, NY: W. W. Norton & Co.Google Scholar
  36. Zetzel, E. R. (1956). Current concepts of transference. International Journal of Psychoanalysis, 37, 369–376.PubMedGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Adam O. Horvath
    • 1
    • 2
  • Peter Muntigl
    • 1
  1. 1.Simon Fraser UniversityBurnabyCanada
  2. 2.University CatolicaSantiagoChile

Personalised recommendations