CoChat
Sign Up
Cited by 441Psychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology ResearchCounseling Practices and Supervision

The DOI matches its Crossref record; 118 of the 118 references it cites were found in a registry or an index.

Therapeutic alliance as a mediator of change: A systematic review and evaluation of research

Baier, Allison L., Kline, Alexander C., Feeny, Norah C.·2020·Clinical Psychology Review
DOI 10.1016/j.cpr.2020.101921
Open this paper in CoChat — free account

Abstract

The alliance-outcome relationship has been consistently linked to positive treatment outcomes irrespective of psychotherapy modality. However, beyond its general links to favorable treatment outcomes, it is less clear whether the alliance is a specific mediator of change and thus a possible mechanism underlying psychotherapy response. This systematic review evaluated research examining the alliance as a potential mediator of symptom change, reviewing study characteristics of 37 relevant articles examining the alliance-outcome relationship and the extent to which these studies met recommended criteria for mechanistic research. Alliance mediated therapeutic outcomes in 70.3% of the studies. We observed significant heterogeneity across studies in terms of methodology, including timing of alliance assessment, study design, constructs used in mediation models, and analytic approaches. Building on recent methodological advancements, we propose directions for future research examining the putative mediational role of alliance, such as greater uniformity in and attention to study design and statistical methodology. This review highlights the importance of alliance in therapeutic change and discusses how adhering to requirements for process research will improve our ability to more precisely estimate how and to what extent alliance drives therapeutic change.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.cpr.2020.101921

Cites

118 of 118 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 118 references

Cited by

Sorted by citations

Items 201–300 of 440

Related

See all

Metadata

Authors
Baier, A. L., Kline, A. C., & Feeny, N. C.
Affiliations
Case Western Reserve University (US)
Corresponding author
Baier, Allison L.
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2020-12
Volume
82
Pages
101921
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2020.101921
OpenAlex
W3087180323
Cited by
441
References
118
Citations by year
2026: 79 · 2025: 111 · 2024: 105 · 2023: 74 · 2022: 60 · 2021: 12
FWCI
2.89
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01 MH066348)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
Keywords
therapeutic relationship, psychotherapy outcome, symptom change, process research, mechanistic research, mediation analysis, psychotherapy response
MeSH terms
Therapeutic Alliance, Humans, Professional-Patient Relations, Psychotherapy, Research Design, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review