Table 3.
Measurements.
| Authors | Therapeutic relationship measure and rater (c = client-rated, t = therapist-rated) | Moment of assessment | Quality of therapeutic relationship, Mean (Standard deviation) | Relationship between therapeutic relationship and outcome | |
|---|---|---|---|---|---|
| 1a | Andersson et al. (28) | WAI: Working Alliance Inventory, C | Third week of treatment | 5.41 (0.83) | Correlations between the WAI-S and residualized change scores on the primary outcome measures were weak (r = 0.18) and not statistically significant |
| 1b | Andersson et al. (28) | WAI: Working Alliance Inventory, C | Third week of treatment | 5.63 (0.94) | Correlations between the WAI-S and residualized change scores on the primary outcome measures were small (r = 0.13) and not statistically significant |
| 1c | Andersson et al. (28) | WAI: Working Alliance Inventory, C | Fourth week of treatment | 5.45 (1.05) | Correlations between the WAI-S and residualized change scores on the primary outcome measures were small (r = 0.10) and not statistically significant |
| 2a | Anderson et al. (30) | WAI-S: Working Alliance Inventory-Short Form, C | After completion of third session | 5.77 (1.20) | n.a. |
| 2b | Anderson et al. (30) | WAI-S: Working Alliance Inventory-Short Form, C | After completion of third session | 5.85 (1.09) | Higher WAI-S scores in older adults (12-18 years) predicted CGAS at 6-month follow-up (B = .22, t = 2.21, p = 0.03) Higher WAI-S scores predicted compliance with the treatment (B = 0.38), F(1, 80) = 13.10, p = 0.01) |
| 3 | Blake Buffini and Gordon (33) | WAI-S: Working Alliance Inventory-Short Form, C | After participants had accessed support on more than one occasion | 4.30 (1.27) | The strength of the working alliance predicted client satisfaction, explaining 55% of variance in client satisfaction scores (R-square = 0.55; F = 93.85, p < 0.001) |
| 4 | Dölemeyer et al. (34) | WAI-S: Working Alliance Inventory-Short Form, C | After first half of treatment | 6.01 (0.79) | Correlations between the WAI-S measured at end of treatment and residual gain scores on EDE-Q-subscale ‘restrained eating behavior’ were significant and moderate (r = −492), no correlations between WAI-S and binge eating episodes |
| 5 | Knaevelsrud et al. (41) | WAI-S: Working Alliance Inventory-Short Form, C | End of treatment | 6.2 (0.7) | n.a. |
| 6 | Knaevelsrud et al. (40) | WAI-S: Working Alliance Inventory-Short Form, C | Fourth treatment session | 6.09 (0.87) | n.a. |
| 7 | Knaevelsrud and Maercker (42) | WAI-S: Working Alliance Inventory-Short Form, C & T (only client ratings reported) | Fourth treatment session | 5.8 (0.62) | Correlations between the WAI-S and residual gain scores on anxiety were significant and moderate (r = .33) |
| 8 | Knaevelsrud and Maercker (43) | WAI-S: Working Alliance Inventory-Short Form, C & T | End of treatment | Client: 6.3 (0.54) Therapist: 5.8 (.98) |
Correlations between the client-rated WAI-S (at the end of treatment) and treatment outcome were significant and predicted 15% of the variance in post-treatment measures of the IES-R (adjusted R-square = 0.148; F(2, 39) = 8.15, p < 0.05) |
| 9 | Preschl et al. (45) | WAI-S: Working Alliance Inventory-Short Form, C & T | After four weeks | Client: 5.82 (0.80) Therapist (only measured post treatment): 6.04 (.67) |
Correlations between clients' ratings of the subscale ‘tasks’ measured post-treatment and BDI-score at post-treatment in the online group were significant and moderate (r = −0.47), the WAI-S did not significantly predict the BDI residual gain score (r = −0.06) |
| 10 | Topooco et al. (48) | WAI-S: Working Alliance Inventory-Short Form, C | n.a. | 4.95 (0.63) | n.a. |
| 11 | Wagner et al. (49) | WAI-S: Working Alliance Inventory-Short Form, C | After the fourth session | 6.04 (0.83) | Early WAI-S (at mid-treatment) significantly predicted treatment outcome (adjusted R-square = .20; F(2,44) = 6.57, p = 0.003) |
| 12 | Andersson et al. (29) | WAI-S: Working Alliance Inventory-Short Form, n.a. | Third week of treatment | n.a. | Higher degree of working alliance predicted Y-BOCS change score (B = −0.09, SE = 0.04, t = 2.20, p < 0.05) |
| 13 | Bergman Nordgren et al. (31) | WAI-S: Working Alliance Inventory-Short Form, adapted for guided internet interventions, C | Third week | 6.00 (0.80) | Correlations between the WAI-S (at week 3) and residual gain scores on the primary outcome measure were significant and moderate (r = −0.47) |
| 14 | Lindegaard et al. (44) | WAI-S: Working Alliance Inventory-Short Form, adapted for guided internet interventions, C | Third week | n.a. | Correlations between the WAI-S (at week three) and treatment outcome were significant and WAI-S predicted change rate (B = −0.05, 95% CI [−0.072, −0.018], z = −3.22, p = 0.001) |
| 15 | Bisseling et al. (32) | WAI-SR: Working Alliance Inventory-Short Form Revised, C | At the start of week 2 | n.a. | Therapeutic alliance predicted both reduction of psychological distress (B = −0.12; t(114) = −2.656; p = 0.01) and increase of mental well-being (B = 0.23; t(113) = 2.651; p = 0.01) at post treatment |
| 16 | Herbst et al. (8) | WAI-SR: Working Alliance Inventory-Short Form Revised, n.a. | Post treatment | 4.08 (0.78) | Correlations between the WAI-SR and Y-BOCS SR change score were significant and moderate (r = 0.33); a marginal correlation between WAI-SR and the OCI-R change score was significant and small (r = 0.29) |
| 17 | Jasper et al. (38) | WAI-SR: Working Alliance Inventory-Short Form Revised, C | Fifth week | 2.34 (0.98) | Correlations between the subscales ‘agreement on treatment tasks’ and residual gain scores for the therapy outcome measure ‘tinnitus distress’ were significant and moderate (r = 0.40) |
| 18 | Scherer et al. (47) | WAI-SR: Working Alliance Inventory-Short Form Revised, adapted to the online help for women, C | After module 2, 3, 4, and 5 | 3.51 (.69) | Correlations of the WAI-SR and residual gain scores on stress and anxiety outcomes were significant and moderate (PSS: r = 0.451) and strong (STAI-T: r = 0.501). Nearly 40% of the variance in patient satisfaction is explained by the WAI-SR, R-square = .398; F(1, 50) = 33.060, p < 0.001. WAI-SR partly mediates at least the relationship between group condition and patient satisfaction |
| 19 | Gómez Penedo et al. (36) | WAI-I: Working Alliance Inventory for Guided Internet Interventions, C | Post treatment | Task & goal subscale: 3.17 (0.91) Bond subscale: 3.56 (1.15) |
Significant effect of the tasks and goals subscale on the estimated PHQ-9 value at the end of follow-up (B = −1.74, SE = 0.40, 95% CI [−2.52, −0.96], t(206) = −4.37, p < 0.001) |
| 20a | Hadjistavropoulos et al. (37) | Therapeutic Alliance Questionnaire (TAQ), C | After module 6 and prior to completing module 12 | Mid-treatment: 83.47 (13.89) Post-treatment: 83.20 (15.35) |
Mid-treatment TAQ scores were not significantly correlated with PHQ-9 post-treatment scores (controlling for pre-treatment PHQ-9 scores) |
| 20b | Hadjistavropoulos et al. (37) | Therapeutic Alliance Questionnaire (TAQ), C | After module 6 and prior to completing module 12 | Mid-treatment: 85.82 (10.85) Post-treatment: 86.93 (12.42) |
Mid-treatment TAQ scores were not significantly correlated with GAD-7 post-treatment scores (controlling for pre-treatment GAD-7 scores) |
| 21 | Klein et al. (39) | Therapeutic alliance questionnaire (TAQ), C | n.a. | 89.2 (15.1) | n.a. |
| 22 | Duffy et al. (35) | Scale to assess the therapeutic relationship (STAR), C & T | At treatment exit |
STAR-P (Client's perspective), treatment completers: 37.410 (1.543) STAR-C (therapist's perspective), treatment completers: 30.543 (1.500) |
STAR-P, client's perspective: Treatment completers showed a significant increase in STAR-P scores of on average 3.9 points from baseline to average end of treatment (day 46) (95% CI [−5.36, 1.26], t (82)= −3.195, p = 0.002). STAR-C, therapist's perspective: For dropout clients, the STAR-C scores declined significantly by on average 5.4 points from baseline to end of treatment (day 46) (95% CI [2.10, −8.73), t(308) = 3.236, p = 0.001) |
| 23 | Reynolds et al. (46) | Agnew Relationship Measure (ARM), short form, C & T | Weekly |
Client ratings Bond and partnership: 5.97 (1.26); Confidence: 6.19 (1.24); Openness: 5.27 (1.42) Therapist ratings Bond and partnership: 5.72 (.94); Confidence: 5.76 (.99); Openness: 4.73 (1.55) |
n.a. |
If a study did not report certain information, this is indicated with n.a. (not available).
The Working Alliance Inventory is from Horvath and Greenberg (24); the Working Alliance Inventory—Short Form is from Busseri and Tyler (50); the Working Alliance Inventory—Short Form Revised is from Hatcher and Gillaspy (51); the Working Alliance Inventory for Guided Internet Interventions is from Penedo et al. (36); the Therapeutic Alliance Questionnaire is from Bickman et al. (52), the Scale to Assess the Therapeutic Relationship is from McGuire-Snieckus et al. (53), the Agnew Relationship Measure is from Agnew-Davies et al. (54).