The Therapeutic Alliance

Paper Summary:

The paper provides an overview of the relationship between therapeutic alliance and retention with reference to the underlying influence of attachment theory. The paper aims to discover how the therapeutic alliance is perceived by the patient and the therapist and how this perception impacts the decision to continue with therapy, change the procedure or to change to another therapist. A brief overview of the history and significance of the therapeutic alliance is offered as well as a look at the attachment theory. The paper concludes that the therapeutic alliance is an essential component in the positive outcomes of therapy as well as in retention.

Outline:
Introduction
Brief Background to the Understanding of Therapeutic Alliance
The Value of Therapeutic Alliance and its Relationship to Retention
Attachment Theory
Conclusion: The Question of Client and Therapist Perceptions of Therapeutic Alliance

From the Paper:

"In 1934, Sterba defined alliance as the relationship between the reasonable aspects of both the therapist and the client. (Sterba, 1934) Therefore, in order to enable positive outcomes and retention, the client's ego "...needed to be strengthened in its interactions with the therapist" (Delaney, 2006). This process was facilitated by an intense form of understanding and cooperation between therapist and client. The concept of alliance was therefore seen as an indispensable process, whereby the client would accept or acquiesce to the therapist's view and insight into the particular problem, which in turn would increase the likelihood of positive outcomes to the therapy.
"The view of therapeutic alliance was taken further by therapists such as Zetzel, Rogers and Greenson in the 1950s and 1960s. These therapists advanced beyond the theory of transference towards an understanding of the therapeutic alliance as a conscious process, which leads to the development of a situation of trust and cooperation between the client and the therapist."

Sample of Sources Used:

• Attachment Theory. Retrieved March 22, 2008, from http://www.apsa.org/AboutPsychoanalysis/ContributionsofPsychoanalysis/ tabid/211/Default.aspx
• Bachelor A. and Salame R, ( 2000) Participants' Perceptions of Dimensions of the Therapeutic Alliance Over the Course of Therapy. J Psychother Pract Res 9:39-53. Retrieved March 22, 2008, fromhttp://jppr.psychiatryonline.org/cgi/content/full/9/1/39
• Barber J. P. et al. ( 2008) Therapeutic alliance as a predictor of outcome and retention in the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Criminal Justice and Behavior, 35 (1) pp. 99-119
• Bordin, E. (1975). The Working Alliance: Basis for a General Theory of Psychotherapy. Paper presented at the 1975 Annual Conference of the Society for Psychotherapy Research.
• Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working slliance. Psychotherapy: Theory, Research, and Practice, 16, pp. 252-260.

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