The Impact of Initial Factors on Therapeutic Alliance in Individual and Couples Therapy

Michael Knerr, Suzanne Bartle-Haring, Tiffany Mcdowell, Katie Adkins, Robin Ostrom Delaney, Rashmi Gangamma, Tatiana Glebova, Erika Grafsky, Kevin Meyer

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


The study uses 457 clients to investigate the impact of initial client factors on the development of therapeutic alliance. Data were collected longitudinally over the early portion of treatment. Cases included both individual and couple clients, allowing for examination of differences by case type. The study used the Working Alliance Inventory-Shortened Version (Tracey & Kokotovic, 1989) to measure therapeutic alliance. Initial factors considered included age, differentiation levels, prior stress, and depression. Couple clients showed differences from individual clients, and the variability prompted further investigation into relationship satisfaction and commitment as factors influencing the development of therapeutic alliance. Results highlight the increased complexity of developing an alliance with couples, and recommendations are provided for clinicians.

Original languageEnglish (US)
Pages (from-to)182-199
Number of pages18
JournalJournal of marital and family therapy
Issue number2
StatePublished - Apr 2011
Externally publishedYes

ASJC Scopus subject areas

  • Social Psychology
  • Clinical Psychology
  • Social Sciences (miscellaneous)
  • Sociology and Political Science


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