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UBC Theses and Dissertations

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UBC Theses and Dissertations

An exploratory study of the working alliance : its measurement and relationship to therapy outcome Horvath, Adam O.

Abstract

The purpose of this exploratory study was to develop a paper-and-pencil inventory to measure the strength and quality of the Therapeutic Working Alliance. This instrument, the Working Alliance Inventory (WAI), was based on the conceptualization of a Working Alliance developed by Bordin (1975,1976). According to Bordin, the Working Alliance has three components: Bond, Goal, and Task. The WAI was designed to tap the client's and therapist's perceptions of these components of a therapeutic relationship after the third therapy interview. An item pool was developed for the WAI, based upon a survey of the literature. The items formulated were refined and culled on the basis of two successive ratings by groups of expert raters. Following these ratings, the WAI was pilot tested in an analog environment using graduate students in counselling psychology as subjects. Finally, the WAI along with two existing tests, the Counselor Rating Form (CRF) (LaCrosse, 1977) and the Relationship Inventory (R-I) (Barrett-Lennard, 1962), were administered to client-therapist dyads representing a variety of theoretical approaches to psychotherapy. Psychotherapy outcome was measured by adaptations of the Client Posttherapy Questionnaire (Strupp et al., 1964). The results indicated that the WAI had adequate reliability, and evidence was gathered supporting the instrument's construct validity. The analysis of the data suggests that there is a strong correlational relationship between Empathy and the alliance dimension of Bond, and a moderate relationship between Empathy and Goal. The Task dimension was reasonably independent of Empathy. All of the WAI dimensions had low correlations with the concepts measured by the CRF. The client reported Working Alliance Task dimension correlated significantly with satisfaction, change, and composite outcome, while the Goal dimension correlated significantly with satisfaction. All of the therapist reported alliance dimensions correlated significantly with satisfaction and change as well as the composite outcome score. Multiple regression analysis using all of the client predictor variables (Empathy, Trustworthiness, Expertness, Attractiveness, Bond, Task, Goal) suggested that the Task scale of the WAI, which was designed to measure the perceived relevance of therapy events, may be the most efficient therapy outcome prognosticator of the variables investigated. The nature of the sample and the low subject-to-variable ratio in this research suggested that the study must be replicated in order to more firmly establish the stability and generalizability of the findings.

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