City Research Online

Abstract

This study explored the empirical and theoretical evidence on the therapeutic alliance (TA) which is currently said to be the best predictor of therapeutic outcome irrespective of the therapeutic approach. Despite the fact that many TA studies have been undertaken on clients’ perspectives, therapists, and observers on behalf of clients, for over 30 years, there is still a lack of clarity and agreement on a precise TA definition. At a time when therapists face some politically-driven changes that requires evidence on practice, this means on the therapist’s part, there is an even greater need for increased understanding on what intricacies are involved in the TA, including therapists’ perspectives on how the TA is measured to support evidence. Accounts are drawn from participants from various schools of training (psychology, psychotherapy, and counselling). Collectively, these views helped in the construction of a new ‘therapist awareness therapeutic alliance scale’ tested through exploratory factor analysis (EFA). A mixed qualitative and quantitative methodology was employed. The study is discussed within the context of counselling psychology philosophy and an integrative theoretical framework on practice.

Results: The TA factor structure reflected many relational elements attributed to a well known working alliance model on shared goals, tasks and an attachment bond. However, in this study, three latent factors were identified, attributed to therapists’ skills: 1) relationship-building, 2) managing the process, and 3) the relational bond. Relationship-building and managing the process featured significantly higher than the relational bond in developing and maintaining the TA, indicating the TA to be more task-related. Significant findings suggest the new measure could assist practice.

Conclusion: As the driving force in therapy, the TA has implications in training (prepractice) throughout the therapeutic process, and for reflective purposes in clinical supervision regarding best practice and continued professional development (CPD). This study has shown that more emphasis is needed on therapists’ skills, in relationship building and managing how they develop and maintain the TA to protect clients, prior to, and at all points of therapy. Implications on practice are addressed and future suggestions on TA research to support practice are recommended.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Departments:	School of Health & Psychological Sciences > Psychology Doctoral Theses School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses

Export

Downloads