Trajectories of therapeutic alliance in couple versus individual therapy: Three-level models

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

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Research concerning therapeutic alliance and outcome is prevalent but relies heavily on data from individual treatment. In this article, the authors present data from cases in which an individual was seen and cases in which a couple was seen in order to investigate differences in therapeutic alliance and its trajectory depending on case type, therapist experience, and therapist sex. Participants included 96 couples and 52 individuals with 15 therapists from a large Midwestern training clinic for couple and family therapy. Data include the use of the Working Alliance Inventory-Shortened Version, and three-level models were estimated using hierarchical linear modeling. The results highlight differences in the trajectories of individual and couple clients therapeutic alliance, including evidence for a curvilinear trend in work scores for individual clients but not couple clients. The results also highlight differences in the sources of variation for couple cases versus individual cases. There is clearly complexity in the building of alliance with clients in general, and even more so with couple clients.

Original languageEnglish (US)
Pages (from-to)79-107
Number of pages29
JournalJournal of Sex and Marital Therapy
Issue number1
StatePublished - Jan 1 2012
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Psychology


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