Relationship between the working alliance and social support on counseling outcome


  • This article was reviewed and accepted under the editorship of Beverly E. Thorn.

  • This study was supported by a 2006 School of Education and Human Services (SEHS) Investigative Activities Award Program at Oakland University.

    We thank James T. Hansen and Alexandra Dunne-Bryant for helpful feedback during preparation of this manuscript. We also appreciate the cooperation of the SEHS counseling training center staff, the counselors, and the clients who participated in this study.


The purpose of this study was to test the impact of two predictor variables, one representing extratherapeutic factors and one representing relationship factors, on outcome at a university counseling training clinic. A naturalistic design was used to collect session-by-session outcomes on 135 clients seen by 88 counselors. Hierarchical linear modeling was used to test hypotheses about the effects of clients' pretreatment social support (extratherapeutic factor) and working alliance (relationship factor) at session 3 on change over time. Results showed that higher rated alliances predicted greater change over the first 8 sessions. When clients reported poorer social supports, the therapeutic alliance was even more important in predicting a positive outcome. Limitations of the design and implications for further outcome studies are discussed. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1–11, 2011.