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The Role of Therapeutic Alliance in Mindfulness Interventions: Therapeutic alliance in Mindfulness Training for Smokers


  • Grant funding was provided by the National Institute on Drug Abuse (K23DA022471, Behavioral Therapy Development Program for Mindfulness Based Smoking Cessation) and by a core grant to the Waisman Center from the National Institute of Child Health and Human Development (P30 HD03352). Support also offered by the University of Wisconsin School of Medicine and Public Health Center for Tobacco Research and Intervention.

Please address correspondence to: Simon Goldberg, Department of Counseling Psychology, University of Wisconsin, 335 Education Building-1000 Bascom Mall, Madison, WI, 53706. E-mail:



Mindfulness-based interventions have enjoyed a marked increase in support within biomedical and psychological research and practice in the past two decades. Despite the widespread application of these treatments for a range of psychological and medical conditions, there remains a lack of consensus regarding mechanisms through which these interventions effect change. One plausible yet underexplored mechanism is the therapeutic alliance between participants and mindfulness instructors.


In this report, data are presented on therapeutic alliance from the mindfulness arm (n = 37) of a randomized controlled trial of a mindfulness-based smoking cessation treatment.


Results suggest that client-reported therapeutic alliance measured midtreatment did not significantly predict primary smoking outcomes. Alliance did predict improvement in posttreatment scores on several outcome variables linked to mindfulness practice, including emotion regulation (β = −.24, p = .042), mindfulness (β = .33, p = .007), negative affect (β = −.33, p = .040), as well as treatment compliance (β = .39, p = .011).


Implications of these relationships and the possible role of therapeutic alliance in mindfulness treatments are explored.