Therapeutic Alliance

The strength of the therapeutic alliance (TA) and the impact it has on the success of psychotherapy is an area that has been extensively researched over the years (Falkenström, Granström, & Holmqvist, 2014; Hendriksen, Peen, Van, Barber, & Dekker, 2014; Schechter, Goldblatt, & Maltsberger, 2013). This review will highlight the key research findings and issues surrounding the TA and its influence on the clinical practice of psychotherapy.

The concept of the TA stems largely from Bordin’s influential definition of the term ‘working alliance’ (WA) (Bordin 1979, as cited in (C. Gelso, 2014; Samardžić & Nikolić, 2014; Horvath, Flückiger, Del Re, & Symonds, 2011). Bordin’s definition accentuates the importance of the client-therapist relationship and their agreement on key aspects of the therapy including the proposed goals, the tasks associated with achieving those goals, and the emotional bond between the therapist and client. When this can be achieved it provides a great foundation for the therapist and client to develop a relationship strong enough to withstand the emotional ups and downs and conflicts that are present within the majority of therapies (Gelso, 2011, as cited in Gelso, 2014). However, too often the WA concept is used to represent the TA as a whole (C. Gelso, 2014).

Recent researchers have advised against referring to the WA and the TA as equivalent (Gelso, 2014; Marmarosh et al. 2009; Horvath, 2009 & Gelso, 2009), suggesting that the TA is a multidimensional construct which represents much more than the WA alone. The WA is now understood to be only one component of what makes a successful therapeutic relationship. Through further research in the field a number of additional factors have emerged which appear to pla...

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...fluence on both session-by-session outcome and overall treatment outcome.

- The first measure to assess the real-relationship in psychotherapy was developed by Gelso et al., (2005). This measure obtained feedback exclusively from the therapist with results showing that there was a moderate to strong correlation between the real relationship and the factors used to measure session outcome. Furthermore, this strong real relationship was found to develop insight in the client due to the sense of safety that is established by a good relationship (C. J. Gelso et al., 2005).

- Furertes

- Marmarosh

- Self disclosure from the therapist is also seen to help the client see the therapist a being real and human, thus increasing the real relationship Barrett & Berman, 2001.

Para 6: Transference & Countertransference

Para 7: Studies that have looked at T & CT

Para 8: Conclusion?