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Research on the alliance: Knowledge in search of a theory
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OBJECTIVES: The aim of this review paper is to summarize the challenges facing research on the alliance now and going forward. The review begins with a brief overview of the development of the concept of the alliance in historical context. METHOD: A summary of what has been accomplished both within the psychotherapy research community and in other professions is presented. Current challenges facing this line of research are identified, including the existence of a wide range of operational definitions that results in a diffusion of the identity of the alliance concept. It is argued that the current situation generates risks to incremental growth in several lines of research. CONCLUSIONS: A case is made that a lack of clarity regarding how several variables within the broader category of therapeutic relationships fit together, overlap, or complement each other is also potentially problematic. Efforts to resolve the lack of a consensual definition are reviewed, and in conclusion, it is argued that a resumption of a conversation about the relationship in the helping context in general, and the alliance in particular, should be resumed.
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“Alliance is considered a generic common factor, with meaning and usefulness expected to be preserved across theoretical orientations [2] and evidence suggests that a range of technology-based interventions can facilitate alliance [36].”
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Cited by
Sorted by citations
The alliance in adult psychotherapy: A meta-analytic synthesis
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018) · Psychotherapy · doi:10.1037/pst0000172 · Cited by 1,763
“More research is also needed that examines the boundary conditions of the alliance measures and their interaction to interpersonal and general process indicators, such as empathy, the real relationship, and corrective experiences (Horvath, 2017).”
BackgroundSelf-citationYin, S., & Yu, Y. (2022) · Journal of Cleaner Production · doi:10.1016/j.jclepro.2022.132608 · Cited by 404
The alliance in mental health care: conceptualization, evidence and clinical applications
Wampold, B. E., & Flückiger, C. (2023) · World Psychiatry · doi:10.1002/wps.21035 · Cited by 261
Flückiger, C., Rubel, J., Del Re, A. C., Horvath, A. O., Wampold, B. E., Crits-Christoph, P., Atzil-Slonim, D., Compare, A., Falkenström, F., Ekeblad, A., et al. (2020) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000594 · Cited by 180
“…meta-analytic synthesis of the overall association between the alliance assessed early in treatment and treatment outcome indicated that the early alliance predicted on average 5% of the variance in therapy outcomes including dropout rates (k 295; Flückiger, Del Re, Wampold, & Horvath, 2018).”
BackgroundInfluentialSelf-citationFlückiger, C., Re, A. C. D., Wlodasch, D., Horvath, A. O., Solomonov, N., & Wampold, B. E. (2020) · Journal of Counseling Psychology · doi:10.1037/cou0000424 · Cited by 137
Self-citation
Metadata
- Authors
- Horvath, A. O.
- Affiliations
- Simon Fraser University (CA)
- Corresponding author
- Horvath, Adam O.
- ORCID
- Horvath, Adam O.
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2017-09-13
- Volume
- 28
- Issue
- 4
- Pages
- 499-516
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W2755354210
- Cited by
- 137
- References
- 126
- Citations by year
- 2026: 14 · 2025: 12 · 2024: 12 · 2023: 18 · 2022: 26 · 2021: 24 · 2020: 20 · 2019: 4 · 2018: 6 · 2017: 1
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Simon Fraser University (90140)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Counseling Practices and Supervision
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- therapeutic relationship, alliance theory, operational definitions, helping relationship
- MeSH terms
- Therapeutic Alliance, Humans, Psychological Theory
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