Therapeutic alliance: Its place as a process and outcome variable in dynamic psychotherapy research.

Argues that conceptual unclarity has surrounded psychotherapy research efforts to define and measure the therapeutic alliance. A precisely defined conception of the therapeutic alliance is offered that focuses on the patient's active collaboration in the tasks appropriate to the treatment process. The therapeutic alliance is thus distinguished from patient characteristics and attitudes as well as from therapist contributions to the formation of the alliance. The importance of the therapeutic alliance as a change measure in process research is underscored, and its place as a primary indicator of outcome is described. Empirical studies are reviewed, with particular reference to the Menninger Treatment Interventions Project, and the use of single-case methodology is considered. The special relevance of the therapeutic alliance to the investigation of the therapeutic change process with borderline patients is outlined. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)