A Longitudinal Analysis of Factors Associated with Therapeutic Alliances

This study examined the impact, on therapeutic alliances, made by client motivation to change, insight, mistrust, and other factors; as well as therapist’s clinical experience. This secondary data analysis used a sample of 212 client respondents extracted from the Treatment of Depression Collaborative Research Program’s data set. Results of generalized least squares random-effects modeling showed a significant impact exerted by client social-adjustment difficulties, insight, alcohol use, and gender; and client–therapist matching gender. Also, four elements of therapeutic alliances—regard, empathic understanding, unconditionality, and congruence—had four unique patterns of significant factors. To foster therapeutic alliances, therapists need to help clients develop awareness of and insight into the clients’ social-adjustment difficulties; therapists should also be particularly sensitive to expectations of clients of the opposite sex. Implications for future research are suggested.