Cited by 1,501Psychotherapy Techniques and ApplicationsCounseling Practices and SupervisionCounseling, Therapy, and Family Dynamics

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Factor structure of the working alliance inventory

Tracey, Terence J., Kokotovic, Anna M.·1989·Psychological Assessment: A Journal of Consulting and Clinical Psychology

DOI 10.1037/1040-3590.1.3.207

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Abstract

The Working Alliance Inventory (WAI) was completed after the 1st psychotherapy session by 84 university counseling center clients and 15 therapists rating their work with 123 clients

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Significance tests and goodness of fit in the analysis of covariance structures.
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A Reliability Coefficient for Maximum Likelihood Factor Analysis
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The generalizability of the psychoanalytic concept of the working alliance.
Bordin, E. S. (1979) · Psychotherapy: Theory, Research & Practice · doi:10.1037/h0085885 · Cited by 5,238
Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size.
Marsh, H. W., Balla, J. R., & McDonald, R. P. (1988) · Psychological Bulletin · doi:10.1037/0033-2909.103.3.391 · Cited by 3,953
Development and validation of the working alliance inventory
Horvath, A. O., & Greenberg, L. S. (1989) · Journal of Counseling Psychology · doi:10.1037//0022-0167.36.2.223 · Cited by 3,520
The psychotherapeutic process: A research handbook.
Greenberg, L. S., & Pinsof, W. M. (1986) · Cited by 1,386
The development of the Working Alliance Inventory.
Horvath, A. O., & Greenberg, L. S. (1986) · Cited by 529
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Gelso, C. J., & Carter, J. A. (1985) · The Counseling Psychologist · doi:10.1177/0011000085132001 · Cited by 515
Two Helping Alliance Methods for Predicting Outcomes of Psychotherapy
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Horowitz, M. J. (1984) · Archives of General Psychiatry · doi:10.1001/archpsyc.1984.01790160024002 · Cited by 208

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Cooper, M., Wild, C., van Rijn, B., Ward, T. J., McLeod, J., Cassar, S., Antoniou, P., Michael, C., Michalitsi, M., & Sreenath, S. (2015) · Counselling Psychology Review · doi:10.53841/bpscpr.2015.30.1.6 · Cited by 23
Psychophysiological Predictors of Working Alliance Among Treatment‐Seeking Women With Complex Trauma Exposure
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The Strengthening Communities For Youth (SCY) Initiative: A Cluster Analysis of the Services Received, Their Correlates and How They are Associated with Outcomes
Dennis, M. L., Ives, M. L., White, M. K., & Muck, R. D. (2008) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2008.10399757 · Cited by 23
Specificities of Defense Mechanisms in Bipolar Affective Disorder
Kramer, U., de Roten, Y., Perry, J. C., & Despland, J. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181b3b224 · Cited by 23
“A 12-item short version has been developed by Tracey and Kokotovic (1989), based on factor-analytic procedures.”
Method
Client Outcomes and the Working Alliance in Assertive Community Treatment Programs
Calsyn, R. J., Morse, G. A., Klinkenberg, W. D., & Lemming, M. R. (2004) · Care management journals · doi:10.1891/152109804780944549 · Cited by 23
Group Questionnaire: A New Measure of the Group Relationship
Krogel, J. (2006) · PsycEXTRA Dataset · doi:10.1037/e514382007-001 · Cited by 23
Attachment theory within clinical supervision: application of the conceptual to the empirical
Wrape, E. R., Callahan, J. L., Rieck, T., & Watkins, C. E. (2017) · Psychoanalytic Psychotherapy · doi:10.1080/02668734.2016.1261927 · Cited by 22
“…ranging from .83 to .94 for attachment avoidance and .46 to .54 for attachment-related anxiety.3 Working Alliance Inventory – Short Version (WAI-SVEE; Tracey & Kokotovic, 1989) Adapted from the Working Alliance Inventory (Horvath & Greenberg, 1989), this briefer, 12-item measure has been used in…”
Method
Examining the Relationship Between Working Alliance and Therapeutic Goal Attainment With Adolescents in Crisis
Schmit, E. L., Balkin, R. S., Hollenbaugh, K. M. H., & Oliver, M. (2017) · Journal of Child and Adolescent Counseling · doi:10.1080/23727810.2017.1351773 · Cited by 22
“The WAI-S consists of a 7-point scale.”
The Relationship Between Working Alliance and Symptom Improvement in Cognitive Therapy for Posttraumatic Stress Disorder
Beierl, E. T., Murray, H., Wiedemann, M., Warnock-Parkes, E., Wild, J., Stott, R., Grey, N., Clark, D. M., & Ehlers, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.602648 · Cited by 22
“Working Alliance Therapeutic working alliance was assessed by the patients and therapists using the short version (23) of the WAI at the end of sessions 1, 3, and 5.”
Method
Working Alliance as a Moderator of the Impact of Mentoring Relationships Among Academically At‐Risk Students
Larose, S., Chaloux, N., Monaghan, D., & Tarabulsy, G. M. (2010) · Journal of Applied Social Psychology · doi:10.1111/j.1559-1816.2010.00675.x · Cited by 22
“In Tracey and Kokotovic’s (1989) study, Cronbach’s alphas for the Goal, Task, and Bonding subscales were .”
Method
Psychodynamic Group Psychotherapy: Impact of Group Length and Therapist Professional Characteristics on Development of Therapeutic Alliance
Lorentzen, S., Bakali, J. V., Hersoug, A. G., Hagtvet, K. A., Ruud, T., & Høglend, P. A. (2011) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.758 · Cited by 22
“(2011) The Working Alliance Inventory—Short Form (Tracey & Kokotovic, 1989) is a 12‐item self‐report questionnaire designed to measure different aspects of the patient– therapist relationship.”
BackgroundMethod
Therapist–client relationships in a psychological therapy trial for psychosis and substance misuse
Berry, K., Gregg, L., Hartwell, R., Haddock, G., Fitzsimmons, M., & Barrowclough, C. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.04.006 · Cited by 22
Therapeutic alliance between youth and staff in residential group care: Psychometrics of the therapeutic alliance quality scale
Hurley, K. D., Lambert, M. C., Ryzin, M. J. V., Sullivan, J. R., & Stevens, A. L. (2012) · Children and Youth Services Review · doi:10.1016/j.childyouth.2012.10.009 · Cited by 22
“…psychometric properties that have been used with youth in traditional psychotherapy settings (Bickman et al., 2010, 2012; Fjermestad et al., 2012; Hawley & Weisz, 2005; Horvath & Greenberg, 1989; Kazdin, Marciano, & Whitley, 2005; McLeod & Weisz, 2005; Shirk & Saiz, 1992; Tracey & Kokotovic, 1989).”
Method
A Randomized Trial of Two Forms of Cognitive Behaviour Therapy for an Older Adult Population with Subclinical Health Anxiety
Bourgault-Fagnou, M. D., & Hadjistavropoulos, H. D. (2012) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2012.717302 · Cited by 25
“The WAI has demonstrated good psychometric properties including high internal consistency and test-retest reliability (Tracey & Kokotovic, 1989).”
Background
Fluctuations in alliance and use of techniques over time: A bidirectional relation between use of “common factors” techniques and the development of the working alliance
Solomonov, N., McCarthy, K. S., Keefe, J. R., Gorman, B. S., Blanchard, M. P., & Barber, J. P. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2143 · Cited by 22
Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales
Luther, L., Fukui, S., Garabrant, J. M., Rollins, A. L., Morse, G. A., Henry, N. H., Shimp, D., Gearhart, T., & Salyers, M. P. (2018) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-018-9601-3 · Cited by 22
“Client-rated working alliance The working alliance was assessed with the short form of the client version of the Working Alliance Inventory (WAI).(35,36) This version of the WAI contains 12 items that a client is asked to rate on a 7-point Likert scale (1 = never to 7 = always).”
Correlates of Therapeutic Alliance and Treatment Outcomes Among Israeli Female Methadone Patients
Schiff, M., & Levit, S. (2009) · Research on Social Work Practice · doi:10.1177/1049731509347854 · Cited by 22
Gruppenklima, Kohäsion, Allianz und Empathie als Komponenten der therapeutischen Beziehung in Gruppenpsychotherapien - Überprüfung eines Mehrebenen-Modells
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Religion and couple therapy: Description and preliminary outcome data.
Hook, J. N., Worthington, E. L., Davis, D. E., & Atkins, D. C. (2013) · Psychology of Religion and Spirituality · doi:10.1037/a0035412 · Cited by 22
Which factors predict case management services and how do these services relate to client outcomes?
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Process, life events, and symptomatic change in brief eclectic psychotherapy.
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Are patient and therapist characteristics associated with the use of defence interpretation in brief dynamic psychotherapy?
Hersoug, A. G., Bøgwald, K., & Høglend, P. A. (2003) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.372 · Cited by 22
GAMBLINGLESS: for LIFE study protocol: a pragmatic randomised trial of an online cognitive-behavioural programme for disordered gambling
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“client and therapist on how to achieve the goals, and the bond subscale examines the development of a personal bond between the client and therapist.(72) The WAI-S total scores range from 7 to 84 with higher scores indicative of a stronger therapeutic relationship.”
Background
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Barger, A. S. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1364054 · Cited by 27
The short Working Alliance Inventory in parent training: Factor structure and longitudinal invariance
Hukkelberg, S. S., & Ogden, T. (2016) · Psychotherapy Research · doi:10.1080/10503307.2015.1119328 · Cited by 21
“This is a popular and readily available self-report questionnaire that has demonstrated high reliability (Hatcher & Gillaspy, 2006; Tracey & Kokotovic, 1989).”
BackgroundMethod
Relating Therapist Characteristics to Client Engagement and the Therapeutic Alliance in an Adolescent Custodial Group Substance Misuse Treatment Program
Daniels, R. A., Holdsworth, E., & Tramontano, C. (2017) · Substance Use & Misuse · doi:10.1080/10826084.2017.1299181 · Cited by 21
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“As recommended [27], both patients and physical therapists completed the WAI separately, after their second consultation (approximately week 4 of the intervention).”
BackgroundMethodInfluential
Validity and reliability of the Lesbian, Gay, Bisexual Working Alliance Self-Efficacy Scales.
Burkard, A. W., Pruitt, N. T., Medler, B. R., & Stark-Booth, A. M. (2009) · Training and Education in Professional Psychology · doi:10.1037/1931-3918.3.1.37 · Cited by 21
“Research on the working alliance has demonstrated that poorly developed alliances are correlated with noncompliance in clients (Eisenthal, Emery, Lazare, & Udin, 1979), poor client outcomes (Alexander & Luborsky, 1986), and premature termination (Tracey & Kokotovic, 1989).”
Background
Therapeutic Alliance in Justice-Involved Adolescents Undergoing Mental Health Treatment: The Role of Callous-Unemotional Traits
Simpson, T. P., Frick, P. J., Kahn, R. E., & Evans, L. J. (2013) · International Journal of Forensic Mental Health · doi:10.1080/14999013.2013.787559 · Cited by 21
“Further, prior factor analysis provides support for a bi-factor model consisting of three subscales that load onto a general therapeutic alliance factor (Tracey & Kokotovic, 1989).”
Method
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Stolovy, T., Levy, Y. M., Doron, A., & Melamed, Y. (2012) · International Journal of Social Psychiatry · doi:10.1177/0020764012461206 · Cited by 21
“The working Alliance Inventory (WAI-S; Tracy & Kokotovic, 1989) is a 12-item short version of Horvarth and Greenberg’s (1989) 36-item scale for measuring the quality of treatment alliance.”
Method
The termination phase: Therapists’ perspective on the therapeutic relationship and outcome.
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“The present study used the therapist version of a 12-item short form of the WAI (WAI-S; Tracey & Kokotovic, 1989) to measure therapist ratings of the working alliance with their client during the termination phase of treatment.”
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“Additionally, in order to evaluate whether changes in young people’s levels of psychological distress is mediated by the quality of the relationship that they have with a professional (either counsellors or pastoral care teachers), and/or the quality of the alliance that they experience with their counsellor (for thos…”
BackgroundMethod
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Darnall, B. D., Ziadni, M. S., Roy, A., Kao, M. J., Sturgeon, J. A., Cook, K. F., Lorig, K. R., Burns, J. W., & Mackey, S. (2018) · Trials · doi:10.1186/s13063-018-2537-3 · Cited by 21
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Anxiety's Effect on the Experience of Supervision of Genetic Counseling Students
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Bentley, P., & Welfare, L. E. (2013) · The Journal of Humanistic Counseling · doi:10.1002/j.2161-1939.2013.00045.x · Cited by 29
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Hellerstein, D. J., Erickson, G., Stewart, J. W., McGrath, P. J., Hunnicutt‐Ferguson, K., Reynolds, S. K., O’Shea, D., Chen, Y., Withers, A., & Wang, Y. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.10.015 · Cited by 22
Gay and bisexual male clients' perceptions of counseling: The role of perceived sexual orientation similarity and counselor universal-diverse orientation.
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Changes in parental depression symptoms during family preservation services
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Características psicométricas de la versión española del Working Alliance Inventory-Short (WAI-S)
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“Treatment process is assessed using the Working Alliance Inventory-12 item (WAI-12) [28].”
Method
Pragmatic randomised controlled trial of group psychoeducation versus group support in the maintenance of bipolar disorder
Morriss, R. K., Lobban, F. A., Jones, S. H., Riste, L., Peters, S., Roberts, C., Davies, L. M., & Mayes, D. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-114 · Cited by 20
“Participants are asked to provide feedback specifically on group cohesion [47] and group working alliance (WAI-S) [48] which are administered at weeks 3, 10 and 21 of follow-up.”
Adult Attachment, Multidimensional Perfectionism, and the Alliances Among Counselor Supervisees
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Investigating Supervisory Relationships and Therapeutic Alliances Using Structural Equation Modeling
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Adapting Schema Therapy for Personality Disorders in Older Adults
Videler, A. C., Royen, R. J. J. V., Heijnen-Kohl, S., Rossi, G. M. P., van Alphen, S. P. J., & Feltz-Cornelis, C. M. V. D. (2017) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2017.10.1.62 · Cited by 20
A multivariate dynamic systems model for psychotherapy with more than one client.
Butner, J., Deits‐Lebehn, C., Crenshaw, A. O., Wiltshire, T. J., Perry, N. S., de Grey, R. G. K., Hogan, J. N., Smith, T. W., Baucom, K. J. W., & Baucom, B. (2017) · Journal of Counseling Psychology · doi:10.1037/cou0000238 · Cited by 20
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Jones, S. H., Riste, L., Barrowclough, C., Βartlett, P., Clements, C., Davies, L. M., Holland, F., Kapur, N., Lobban, F. A., Long, R., et al. (2018) · Programme Grants for Applied Research · doi:10.3310/pgfar06060 · Cited by 20
On understanding the role and significance of a key two-person relationship in sport and executive coaching
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The Working Alliance in Group Counseling: An Exploratory Study
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“In addition, a good therapeutic alliance is strongly associated with decreased rates of dropout from therapy ( Arnow, Blasey, Manber, Constantino, Markowitz, Klein, et al., 2007 ) and lower rates of premature termination ( Tracey & Kokotovic, 1989 ; Tryon & Kane, 1993 ).”
Background
Shifting Perspectives
Ross, L., Polaschek, D. L. L., & Wilson, M. (2011) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x11384948 · Cited by 20
“…has become the most widely used and well-known measure of therapeutic alliance and as such its psychometric structure has been explored (Andrusyna, Tang, DeRubeis, & Luborsky, 2001; Corbiere, Bisson, Lauzon, & Ricard, 2006; Hatcher & Barends, 1996; Hatcher & Gillaspy, 2006; Tracey & Kotovic, 1989).”
BackgroundMethodInfluential
Psychometric properties of the Spanish version of the Working Alliance Theory of Change Inventory (WATOCI)
Corbella, S., & Botella, L. (2004) · Psicothema · Cited by 20
The intensity of breast cancer patients' relationships with their surgeons after the first meeting: Evidence that relationships are not ‘built’ but arise from attachment processes
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“From 45 published studies in which the WAI was used to measure intensity of clinical relationships, we identified 72 measurements of alliance (Figure 1).”
MethodInfluential
Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder: a mixed-methods approach
Morrison, A. P., Law, H., Barrowclough, C., Bentall, R. P., Haddock, G., Jones, S. H., Kilbride, M., Pitt, E., Shryane, N. M., Tarrier, N., et al. (2016) · Programme Grants for Applied Research · doi:10.3310/pgfar04050 · Cited by 24
“Measures to assess therapeutic alliance and adherence Engagement in therapy was assessed by means of the Working Alliance Inventory (WAI) (Short Form, therapist and client versions).(330) Treatment fidelity was assessed by both the Cognitive Therapy Scale Revised Version(331) and the RfCBT fidelity scale specifically…”
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Outcomes, skill acquisition, and the alliance: Similarities and differences between clinical trial and student therapists
Goldstein, L. A., Mandel, A. A., DeRubeis, R. J., & Strunk, D. R. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103608 · Cited by 19
The Therapeutic Alliance and CBASP-Specific Skill Acquisition in the Treatment of Chronic Depression
Santiago, N. J., Klein, D., Vivian, D., Arnow, B., Blalock, J., Kocsis, J., Markowitz, J., Manber, R., Riso, L. P., Rothbaum, B., et al. (2005) · Cognitive Therapy and Research · doi:10.1007/s10608-005-9638-5 · Cited by 20
“The early therapeutic alliance was assessed using the abbreviated patient report version of the WAI (Horvath & Greenberg, 1989; Tracey & Kokotovic, 1989), which was administered in week 2 (after 3–4 sessions) of the trial.”
MethodInfluential
Readiness to Change as a Predictor of Treatment Engagement and Outcome for Partner Violent Men
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“Tracey and Kokotovic (1989) created the WAI-S from the full 36-item WAI (Horvath & Greenberg, 1986) by selecting the items that best represented each of the three empirically identified factors.”
BackgroundMethodInfluential
Goals Form: Reliability, validity, and clinical utility of an idiographic goal‐focused measure for routine outcome monitoring in psychotherapy
Cooper, M., & Xu, D. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23344 · Cited by 20
“This compared against a mean rating of 3.7 for the PHQ‐9 (SD = 1.0), which had been used on a session‐by‐session basis throughout psychotherapy; and 3.1 (SD = 1.0) on theWorking Alliance Inventory—Short Form (Tracey & Kokotovic, 1989), which had been used at review points.”
MethodInfluential
Expecting change: Mindset of staff supporting parents with mild intellectual disabilities
Meppelder, M., Hodes, M. W., Kef, S., & Schuengel, C. (2014) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.08.015 · Cited by 20
Characteristics of Individuals with Spinal Cord Injury Who Use Cannabis for Therapeutic Purposes
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The Alliance Negotiation Scale: A psychometric investigation.
Doran, J. M., Safran, J. D., & Muran, J. C. (2015) · Psychological Assessment · doi:10.1037/pas0000222 · Cited by 24
Measurement properties of the Brazilian version of the Working Alliance Inventory (patient and therapist short-forms) and Session Rating Scale for low back pain
Araújo, A. C., Filho, R. N., Oliveira, C. B., Ferreira, P. H., & Pinto, R. Z. (2017) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-160563 · Cited by 19
“Previous studies reported Cronbach’s alpha for the WAI subscales varying between 0.85 and 0.90 [28,37].”
Influential
Pilot trial of cognitive and behavioral treatment for hoarding disorder delivered via webcam: Feasibility and preliminary outcomes
Muroff, J. R., & Steketee, G. S. (2018) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2018.05.002 · Cited by 19
A relational perspective on the association between working alliance and treatment outcome
Uckelstam, C.-J., Holmqvist, R., Philips, B., & Falkenström, F. (2018) · Psychotherapy Research · doi:10.1080/10503307.2018.1516306 · Cited by 19
“The current study used the 12-item revised version, WAI-SR for patient ratings (Hatcher & Gillaspy, 2006), and WAI-S for therapist ratings (Tracey & Kokotovic, 1989).”
Method
Effect of individual career counseling on psychological distress: impact of career intervention components, working alliance, and career indecision
Milot‐Lapointe, F., Savard, R., & Corff, Y. L. (2019) · International Journal for Educational and Vocational Guidance · doi:10.1007/s10775-019-09402-6 · Cited by 19
Reevaluating ruptures and repairs in alliance: Between- and within-session processes in cognitive–behavioral therapy and short-term psychodynamic psychotherapy.
Zlotnick, E., Strauss, A. Y., Ellis, P., Abargil, M., Tishby, O., & Huppert, J. D. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000598 · Cited by 20
The therapeutic relationship in telephone-delivered support for people undertaking rehabilitation: a mixed-methods interaction analysis
Müller, I., Kirby, S. E., & Yardley, L. (2014) · Disability and Rehabilitation · doi:10.3109/09638288.2014.955134 · Cited by 19
“Bivariate correlations were carried out between the WAI-S subscales (goal, task and bond) and the RIAS composite categories (relationship building, therapist dominance and person-centredness) to establish whether or not a relationship between these variables exists.”
MethodInfluential
Perceptions of the quality of the therapeutic alliance in chiropractic care in The Netherlands: a cross-sectional survey
Lambers, N. M., & Bolton, J. E. (2016) · Chiropractic & Manual Therapies · doi:10.1186/s12998-016-0100-4 · Cited by 21
“(DOCX 96 kb) Abbreviations WAI: working alliance inventory; WAV: Werkalliantie Vragenlijst (Validated translation into Dutch from WAI).”
BackgroundResultInfluential
Counselors’ attachment anxiety and avoidance and the congruence in clients’ and therapists’ working alliance ratings
Kivlighan, D. M., & Marmarosh, C. L. (2016) · Psychotherapy Research · doi:10.1080/10503307.2016.1198875 · Cited by 26
“Higher scores indicate a stronger WA. Research by Tracey and Kokotovic (1989) demonstrates that the WA consists of a large global, nonspecific alliance factor.”
Background
Two brief valid measures of therapeutic alliance in counseling for tobacco dependence
Warlick, C. A., Richter, K. P., Catley, D., Gajewski, B. J., Martin, L. E., & Mussulman, L. M. (2017) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2017.12.010 · Cited by 19
Asian Americans' and African Americans' Initial Perceptions of Hispanic Counselors
Fuertes, J. N. (1999) · Journal of Multicultural Counseling and Development · doi:10.1002/j.2161-1912.1999.tb00219.x · Cited by 19
Implementing Attachment-Based Family Therapy for Depressed and Suicidal Adolescents and Young Adults in LGBTQ+ Services: Feasibility, Acceptability, and Preliminary Effectiveness
Russon, J., Morrissey, J., Dellinger, J., Jin, B., & Diamond, G. (2022) · Crisis · doi:10.1027/0227-5910/a000821 · Cited by 18
Internet-based grief therapy for bereaved individuals after loss due to haematological cancer: study protocol of a randomized controlled trial
Hoffmann, R., Große, J., Nagl, M., Niederwieser, D., Mehnert, A., & Kersting, A. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1633-y · Cited by 18
“Working alliance Working Alliance Inventory Short Form (WAI-S) [54, 99] (only Monitoring and T1) 12 never-always (1–7) intervention α=.”
MethodInfluential
Pathways to Working Alliances: Special Educators’ Emotional Labor and Relationships with Students with Emotional and Behavioral Disorders
Valenti, M., Brown, E. L., Horner, C. G., Mahatmya, D., & Colditz, J. B. (2019) · Teachers College Record The Voice of Scholarship in Education · doi:10.1177/016146811912100708 · Cited by 18
Predictors and moderators of treatment dropout in cognitive-behavioral and psychodynamic therapies for panic disorder
Keefe, J. R., Chambless, D., Barber, J., & Milrod, B. (2020) · Psychotherapy Research · doi:10.1080/10503307.2020.1784487 · Cited by 9
“For patients completing session 2 of psychotherapy, the widely used Working Alliance Inventory-Self Report (Tracey & Kokotovic, 1989) and the expectancy scale from (Devilly & Borkovec, 2000) were given.”
Method
Autistic-Delivered Peer Support: A Feasibility Study
Shea, L., Wong, M.-Y., Song, W., Kaplan, K., Uppal, D., & Salzer, M. S. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05816-4 · Cited by 19
“The WAI-S (Tracey & Kokotovic, 1989) was adapted to measure participants’ perceptions of their working relationship with the peer specialist.”
MethodInfluential
Does an emotion‐focused two‐chair dialogue add to the therapeutic effect of the empathic attunement to affect?
Stiegler, J. R., Molde, H., & Schanche, E. (2017) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2144 · Cited by 18
Phone coaching in Dialectical Behavior Therapy: frequency and relationship to client variables
Oliveira, P. N., & Rizvi, S. L. (2018) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2018.1437469 · Cited by 18
“The Working Alliance Inventory short form (WAI-S; Tracey & Kokotovic, 1989) is a widely used 12-item questionnaire used to assess the therapeutic alliance.”
Method
Mediating Effect Of The Motivation For Medication Use On Disease Management And Medication Adherence Among Community-Dwelling Patients With Schizophrenia
Hsieh, W. L., Lee, S. K., Chien, W. T., Liu, W., Lai, C. Y., & Liu, C. (2019) · Patient Preference and Adherence · doi:10.2147/ppa.s218553 · Cited by 18
“The 12-item Working Alliance Inventory-Short (WAI-S) uses a 7-point Likert scale to measure therapeutic alliance, with higher scores indicating better therapeutic alliance.(32) The Cronbach α of WAI-S was.”
Method
Implementation of an intensive short-term dynamic treatment program for patients with treatment-resistant disorders in residential care
Solbakken, O. A., & Abbass, A. A. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-12 · Cited by 18
“Patient rated working alliance is assessed by the Working Alliance Inventory (WAI) [31] short version with 12 items rated on a seve n point scale [40].”
Method
The Impact of Interpersonal Style and Interpersonal Complementarity on the Therapeutic Alliance Between Therapists and Offenders in Sex Offender Treatment
Watson, R., Daffern, M., & Thomas, S. D. M. (2015) · Sexual Abuse · doi:10.1177/1079063215580969 · Cited by 18
“Participants at Marngoneet Correctional Centre completed the IMI-C and WAI-SF while the researcher was present, outside of treatment program time.”
MethodInfluential
Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele‐Interpersonal Psychotherapy for HIV‐infected Rural Persons: Evidence for Indirect Effects
Anderson, T., McClintock, A. S., McCarrick, S. M., Heckman, T. G., Heckman, B. D., Markowitz, J. C., & Sutton, M. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22502 · Cited by 18
“Working Alliance Inventory (WAI; Horvath, 1981; Tracey & Kokotovic, 1989).”
Background
Cumulative Childhood Trauma and Therapeutic Alliance: The Moderator Role of Attachment in Adult Patients Consulting in Sex Therapy
Lafrenaye-Dugas, A.-J., Godbout, N., & Hébert, M. (2018) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2018.1447057 · Cited by 18
“…inventory-client short form (French version) Therapeutic alliance was measured with the French version of the Working Alliance Inventory-Client Short Form (WAI; Tracey & Kokotovic, 1989), which includes three subscales assessing the three elements of Bordin’s (1979) theory as well as a total score.”
Method
Does progress feedback enhance the outcome of group psychotherapy?
Vos, M. M. W. K.-D., Nugter, A., Engelsbel, F., & de Jong, K. (2018) · Psychotherapy · doi:10.1037/pst0000164 · Cited by 20
Die Therapeutische Allianz
Hentschel, U. (2005) · Psychotherapeut · doi:10.1007/s00278-005-0440-3 · Cited by 18
Institutional Therapeutic Alliance and Its Relationship With Outcomes in a Psychiatric Day Hospital Program
Pulido, R. D., Monari, M., & Rossi, N. C. F. (2008) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2007.07.003 · Cited by 18
Goal-Focused Emotion-Regulation Therapy (GET) in Young Adult Testicular Cancer Survivors: A Randomized Pilot Study
Hoyt, M. A., Wang, A. W.-T., Ceja, R. C., Cheavens, J. S., Daneshvar, M. A., Feldman, D. R., Funt, S. A., & Nelson, C. J. (2023) · Annals of Behavioral Medicine · doi:10.1093/abm/kaad010 · Cited by 17
Development of the Internet-Delivered Cognitive Behaviour Therapy Undesirable Therapist Behaviours Scale (ICBT-UTBS)
Hadjistavropoulos, H. D., Gullickson, K. M., Schneider, L. H., Dear, B. F., & Titov, N. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100255 · Cited by 17
“At post-treatment, patients completed the Working Alliance Inventory-Short Revised (WAISR; α=0.90; Tracey and Kokotovic, 1989) and responded to questions about treatment satisfaction (e.g., would you recommend the treatment to a friend (yes/no)?”
MethodInfluential
The “Anxiety Treatment Protocol”: A Group Case Study Demonstration of a Transdiagnostic Group Cognitive—Behavioral Therapy for Anxiety Disorders
Norton, P. J., & Hope, D. A. (2008) · Clinical Case Studies · doi:10.1177/1534650108321307 · Cited by 20
Psychological and relational factors in ESRD hemodialysis treatment in an underserved community
Reyes, M., Fuertes, J. N., Moore, M., Punnakudiyil, G. J., Calvo, L., & Rubinstein, S. (2020) · Patient Education and Counseling · doi:10.1016/j.pec.2020.06.002 · Cited by 17
Mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia: a cross-sectional study
Lee, K. T., Lee, S. K., Lu, M. J., Hsieh, W. L., & Liu, W. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03239-6 · Cited by 17
Potential Role of Nonverbal Synchrony in Psychotherapy: A Meta‐Analysis
Gregorini, C., Carli, P. D., Parolin, L. A. L., Tschacher, W., & Preti, E. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.12885 · Cited by 24
Perspectives of Young Emerging Adults With Serious Mental Health Conditions on Vocational Peer Mentors
Klodnick, V. V., Sabella, K. A., Brenner, C. J., Krzos, I. M., Ellison, M. L., Kaiser, S. M., Davis, M., & Fagan, M. A. (2014) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426614565052 · Cited by 17
“The WAI-S is a 12-item self-report measure of the working alliance between a client and mental health practitioner (Tracey & Kokotovic, 1989).”
Background
When Is Transference Work Useful in Psychodynamic Psychotherapy? Main Results of the First Experimental Study of Transference Work (FEST)
Hersoug, A. G., Ulberg, R., & Høglend, P. A. (2014) · Contemporary Psychoanalysis · doi:10.1080/00107530.2014.880314 · Cited by 17
“The Working Alliance Inventory (Horvath & Greenberg, 1989; Tracey & Kokotovic, 1989) was rated in Session 7.”
Method

Authors: Tracey, T. J., & Kokotovic, A. M.
Affiliations: University of Illinois Urbana-Champaign (US)
ORCID: Tracey, Terence J.
Venue: Psychological Assessment: A Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 1989-09
Volume: 1
Issue: 3
Pages: 207-210
ISSN: 1040-3590 (ISSN-L)
1939-134X
DOI: 10.1037/1040-3590.1.3.207
OpenAlex: W2091499037
Cited by: 1,501
References: 15
Citations by year: 2026: 42 · 2025: 55 · 2024: 54 · 2023: 46 · 2022: 74 · 2021: 81 · 2020: 72 · 2019: 74 · 2018: 104 · 2017: 79 · 2016: 78 · 2015: 85 · 2014: 97 · 2013: 67 · 2012: 72
FWCI: 4.61
Type: journal article
Language: en
Open access: closed
Locations: Psychological Assessment (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
Keywords: Working Alliance Inventory, therapeutic relationship, factor structure, psychotherapy, counseling center clients, therapist ratings

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Factor structure of the working alliance inventory

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