A meta-analytic examination of client–therapist perspectives of the working alliance

Using 53 studies, comprising 52 separate data sets, published in refereed journals from 1985 through 2006, the authors conducted meta-analyses of the correlation and mean difference between client–therapist alliance ratings. Client and therapist alliance ratings were moderately correlated (=.36, SD=.00); clients’ ratings were higher than ratings by their therapists (=.63, SD=.42). Client disturbance was a significant moderator of client–therapist alliance rating discrepancies; clients with milder disturbances or with substance abuse problems tended to have larger rating discrepancies with their therapists than clients with more severe disturbances or moderate disturbance without substance abuse.