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Concept-mapping the client’s perspective on counselling alliance formation Bedi, Robinder Paul

Abstract

The purpose of this study was to identify, categorize, and model clients' understanding of what behaviours are important in the initial formation of a counselling alliance. Forty participants who had participated in actual counselling were interviewed and asked what observable behaviours and verbalizations they thought had helped form or strengthen the alliance with their counsellor. These alliance formation factors (in the form of participant statements) were recorded on index cards and thirtyone participants then returned and sorted these statements into self-defined conceptually homogeneous categories. Multivariate Concept-Mapping statistical techniques were used to compute the "average" sort across the participants. This analytic method yields an aggregate representation of individual understandings using a conceptual structure derived from the participants on the basis of sequential multidimensional scaling, cluster analysis, and three-dimensional plotting procedure. In this study, 74 client-identified common factors were elicited and reliably categorized into the following 11 categories: Setting, Presentation & Body Language, Nonverbal Gestures, Emotional Support & Care, Honesty, Validation, Guidance & Challenge, Education, Referrals & Recommended Materials, Client's Personal Responsibility, and Session Administration. Participants understood adjacent categories in the above list as conceptually more similar constructs, while non-adjacent categories were understood as constructs more distinct from each other. The results indicate a discrepancy between the client's perspective on the alliance, as represented in this study, and those descriptions provided in the literature, which are generally derived from the practitioner's or investigator's perspectives. For example, the participants in this study saw alliance formation as counsellor-driven (rather than as collaborative or as involving much client agency), as affected by the counsellor's physical characteristics (such as attire)as developed largely through simple micro-skills (such as eye contact, identifying client feelings, and referring to information in past sessions), and as impacted notably by technical counsellor activity intended to directly affect outcome. This study also identified under-researched variables for inclusion into future investigations. This paper also discusses the methodological contributions of this research study, the limitations of the research study, and directions for future research.

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