title: Trajectories of therapeutic alliance in couple versus individual therapy: three-level models.
abstract: Research concerning therapeutic alliance and outcome is prevalent but relies heavily on data from individual treatment. In this article, the authors present data from cases in which an individual was seen and cases in which a couple was seen in order to investigate differences in therapeutic alliance and its trajectory depending on case type, therapist experience, and therapist sex. Participants included 96 couples and 52 individuals with 15 therapists from a large Midwestern training clinic for couple and family therapy. Data include the use of the Working Alliance Inventory-Shortened Version, and three-level models were estimated using hierarchical linear modeling. The results highlight differences in the trajectories of individual and couple clients' therapeutic alliance, including evidence for a curvilinear trend in work scores for individual clients but not couple clients. The results also highlight differences in the sources of variation for couple cases versus individual cases. There is clearly complexity in the building of alliance with clients in general, and even more so with couple clients.
authors.affiliation: The Therapeutic Alliance Working Group in the Couple and Family Therapy Program at The Ohio State University, Columbus, Ohio, USA. haringl19@osu.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bartle-Haring
authors.forename: Michael
authors.initials: M
authors.lastname: Knerr
authors.forename: Katie
authors.initials: K
authors.lastname: Adkins
authors.forename: Robin Ostrom
authors.initials: RO
authors.lastname: Delaney
authors.forename: Rashmi
authors.initials: R
authors.lastname: Gangamma
authors.forename: Tatiana
authors.initials: T
authors.lastname: Glebova
authors.forename: Erika
authors.initials: E
authors.lastname: Grafsky
authors.forename: Tiffany
authors.initials: T
authors.lastname: McDowell
authors.forename: Kevin
authors.initials: K
authors.lastname: Meyer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D019546:Couples Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008388:Marital Therapy / Q000379:methods; D015146:Midwestern United States; D008960:Models, Psychological; D057285:Precision Medicine / Q000379:methods* / Q000523:psychology*; D011369:Professional-Patient Relations; D011614:Psychotherapy, Brief / Q000379:methods; D011795:Surveys and Questionnaires; D055815:Young Adult