Therapeutic relationship

Therapeutic relationship

The therapeutic relationship, also called the helping alliance, the therapeutic alliance, and the working alliance, refers to the relationship between a mental health professional and a patient. It is the means by which the professional hopes to engage with, and effect change in, a patient.

Research

While much early work on this subject was generated from a psychodynamic perspective, researchers from other orientations have since investigated this area. It has been found to predict treatment adherence (compliance) and concordance and outcome across a range of patient diagnoses and treatment settings. Research on the statistical power of the therapeutic relationship now reflects more than 1,000 findings [Orlinsky, D. E., Ronnestad, M. H., Willutski, U. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change. In M. J. Lambert (Ed.) Handbook of psychotherapy and behaviour change (5th Ed.). New York: John Wiley & Sons.] .

Operationalization and Measurement

Several scales have been developed to assess the patient-professional relationship in therapy, including the Working Alliance Inventory (WAI) [Horvath, A. O., Greenberg, L. (1986). The development of the Working Alliance Inventory: A research handbook. In L. Greenberg and W. Pinsoff (Eds.) Psychotherapeutic Processes: A Research Handbook, New York: Guilford Press.] , the Barrett-Lennard Relationship Inventory [Barrett-Lennard, G. T. (1962). Dimensions of therapist response as causal factors in therapeutic change. Psychological Monographs: General and Applied, 76, 1-33.] and the California Psychotherapy Alliance Scales (CALPAS) [Gaston L., Marmar, C. R. (1991). Manual for the California Psychotherapy Alliance Scales - CALPAS Unpublished manuscript. Department of Psychiatry McGill University, Montreal, Canada.] . The Scale To Assess Relationships (STAR) was specifically developed to measure the therapeutic relationship in community psychiatry, or within care in the community settings [*"McGuire-Snieckus", R., McCabe, R, Catty, J., Hansson, L., and Priebe, S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychological Medicine, 37, 85-95.] .

ee also

* Clinical psychology

References


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