What is it about?
Clients who report a stronger alliance with their therapist tend to feel better by the next session. This study shows that this effect grows over time and is strongest for people with difficult childhoods. Therapist ratings did not predict improvement.
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Why is it important?
The study highlights that clients’ own experience of the working alliance is key to improvement, especially for those with adverse childhood experiences. Focusing on the client‑rated alliance can strengthen outcomes.
Perspectives
This article is the culmination of five years of collaboration between researchers, supervisors, training therapists, and clients at a university training clinic. It shows how much clients’ moment‑to‑moment experience of the relationship shapes change. It reinforces the value of staying attuned, repairing ruptures, and using the alliance as an active part of therapy.
Ole Karkov Østergård
Department of Culture and Communication, Aalborg University, Denmark
Read the Original
This page is a summary of: The working alliance predicts session-by-session change in problems and functioning in short-term psychodynamic psychotherapy., Journal of Counseling Psychology, March 2026, American Psychological Association (APA),
DOI: 10.1037/cou0000867.
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