PSYC201 Lecture Notes - Lecture 3: Therapeutic Relationship
2 Jun 2018
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Week 3 PSYC201 – Empathy
• Empathy is critically important to the development of the relationship, the
‘therapeutic alliance’ or ‘working alliance’
• Definition
o Putting yourself into ‘another person’s shoes’ or viewing the world
through ‘someone else’s eyes and ears’ is another way to describe
empathy
o Carl Rogers brought importance of empathy to our attention
o It is vital to listen carefully, enter the world of the client and
communicate that we understand the client’s world as the client sees
and experiences it
• What is the therapeutic alliance?
o The therapeutic alliance is thought to be composed of the emotional
bond between patient and therapist, agreement on tasks and agreement
on goals
o Therapeutic alliance has been investigated in therapy from various
perspectives
• Alliance and treatment outcome
o A number of studies have examined the importance of the therapeutic
relationship in treatment outcome
o Varied estimates of the extent to which alliance is important in therapy
and predicts outcome
o Two main views
▪ 1. Alliance is a key aspect of treatment
▪ Several studies have stated that alliance is a ‘strong’ or ‘robust’
predictor of therapeutic outcome
▪ E.g. research indicates that alliance is central to the 30% of
common factors that make for successful psychotherapy
▪ Therefore alliance should be a primary focus for treatment and
training
▪ 2. Second view is that alliance plays a relatively minor role
▪ Some reviews indicate that less than 5% of the variance in
outcome is due to the alliance
▪ Technique is noted as important
▪ Some critiques have argued that we should be looking to the
95% of variance in outcome which is explained by other factors
o A clever study on alliance-outcome (Crits-Christoph et al. 2011)
▪ They looked out how dependable alliance scores are – they
found that if they only took one measure of alliance at one
session, the extent of variance explained was quite small
(reliability was poor)
• What is the theory?
o Early attachment to caregivers
o As children, we develop templates – representations of self, others and
the world
o In the therapeutic relationship, early patterns may be played out
o Therapy may challenge maladaptive templates, leading to
reorganization and growth
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