Author ORCID Identifier

https://orcid.org/0009-0003-6460-3193

Date Available

4-22-2025

Year of Publication

2025

Document Type

Master's Thesis

Degree Name

Master of Science in Family Sciences (MSFS)

College

Agriculture, Food and Environment

Department/School/Program

Family Sciences

Faculty

Dr. Nathan D. Wood

Faculty

Alexander T. Vazsonyi

Abstract

One of the most robust findings in psychotherapy outcome research has been the relationship of a strong therapeutic alliance with improvement in treatment. Most research, however, has measured therapeutic alliance from the client’s point of view, disregarding the therapist’s perspective of this phenomenon. In this naturalistic study of adults in systemic individual, couple, or family psychotherapy (N = 627), both client- and therapist-ratings of alliance were assessed for their associations with treatment outcomes. Multilevel modeling was employed to analyze data from the Marriage and Family Therapy Practice Research Network (MFT-PRN). Client-ratings of the therapeutic alliance and general functioning/relationship satisfaction at the start of treatment were both found to predict outcomes at the end of treatment. However, no association was found for the therapist’s rating of alliance, nor was the therapist’s rating found to moderate the relationship between client-ratings and therapy outcomes. Findings potentially highlight the asymmetric nature of the therapeutic relationship, with the client’s perspective of the alliance more salient for treatment outcomes, as well as the need for routine outcome monitoring to regularly assess therapeutic alliance strength.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2025.07

Download

Included in

Counseling Commons

Share

COinS