Therapeutic Alliance in Psychotherapy: Clinical Significance and Skills Training

Therapeutic alliance is relevant across diverse therapies and has a long history in psychotherapy. Theoretical definitions of the alliance have three common components across the therapy approaches including the collaborative nature of the relationship, the affective bond between client and therapist, and the client’s and therapist’s ability to mutually agree on treatment goals and tasks. Therapeutic alliance scales have the patient’s/ client’s version, the therapist’s version as well as the independent rater versions. The moderating effect of the therapeutic alliance is dependent on the kind of the assessment instrument used. Higher level of therapeutic alliance has been associated with better outcomes across the brief psychotherapies and the relationship between the outcome and alliance was modest. The current chapter covers the concept of therapeutic relationship and its various dimensions, the general principles and role of the therapist. It also covers the desirable personal attributes of the therapist such as being flexible, honest, respectful, trustworthy, confident, warm, interested, genuine and open that contribute positively to the alliance. The chapter also focuses on the methods of training to improve the therapeutic alliance building skills of the therapist.