Building a good therapeutic alliance

The therapeutic alliance - therapist and client working together towards recovery - plays a significant role in psychotherapy and is an important factor in its success and effectiveness. However, the role of the therapist in the development of the alliance has not been extensively investigated and studies of the alliance in long-term psychotherapy are virtually non-existent. Norwegian researchers studied the therapeutic alliance in 201 clients and 61 therapists in long-term (more than 120 sessions) therapy. The higher therapists scored on the cold/detached scale of personality measurement - being distanced, disconnected or indifferent - the worse the alliance. The more professional training the therapists had had the worse the patients rated the quality of the alliance. The more experienced the therapists were the lower they rated the quality of the alliance. Therapists who reported better maternal care up to their adolescence were more likely to have patients who thought they had a good therapeutic alliance.

Hersoug, Anne Grete ... [et al] - Therapist characteristics influencing the quality of alliance in long-term psychotherapy Clinical Psychology and Psychotherapy March-April 2009, 16(2), 100-110