Clients' perception of the therapeutic alliance: A qualitative analysis.

This study examined the therapeutic alliance from the perspective of the involved client, using 66 descriptive accounts provided by 34 clients over 3 phases of therapy. Through phenomenological analysis, 3 relatively distinct types of perceived alliance were identified across therapy, which were labeled nurturant (46% of reports), insight-oriented (39%), and collaborative (15%) to emphasize therapist facilitative attitudes, client improved self-understanding, and client involvement, respectively. A 2nd method of content analysis provided a list of the individual characteristics representative of clients' perceptions and their prevalence within and across the 3 types of alliance. Findings suggest that theoretician-defined alliance variables are not equally relevant for clients and that some crucial features of the perceived working relationship are not accounted for in current alliance theory.