The Strength of the Therapeutic Alliance in Three Treatments for Depression

The present study used the Working Alliance Inventory (WAI) and the Barrett-Lennard Relationship Inventory (BLRI) to examine the nature of the therapeutic alliance in three treatments for depression, Focused Expressive Psychotherapy, Cognitive Therapy, and Supportive/SelfDirected Therapy. Three main findings emerged. First, although intended to measure different aspects of the therapeutic relationship, the WAI, the BLRI, and their subscales were found to intercorrelate highly, indicating that they may all measure essentially the same underlying construct, Strength of the Therapeutic Alliance. Second, as suggested by Strupp, the strength of the therapeutic alliance early in therapy was found to be a good predictor of its strength at the end of therapy. Third, no significant difference was found in the strength of therapeutic alliance among the three forms of therapy. Contrary to what might have been expected, the therapeutic alliance was no weaker in Supportive/Self-Directed Therapy than in Cognitive Therapy or Focused Expressive Psychotherapy.