Deck 14: Assessing the Therapeutic Alliance

Question 1

According to Bordin, the therapeutic alliance is defined as:

A) A client's transference relationship with the counselor
B) Client's emotional bond with the counselor and an agreement on counseling goals and how to achieve them
C) Client and counselor having a mutually agreed upon plan for counseling sessions
D) A positive, non-judgmental, and friendly counselor-client relationship

Answer 1

Client's emotional bond with the counselor and an agreement on counseling goals and how to achieve them

Question 2

According to meta-analysis research the impact the therapeutic alliance has on client improvement at the end of counseling is:

A) Minimal and less important the specific techniques
B) Extremely large
C) Important to a moderate degree
D) Strongly related to the counselor's theoretical orientation

Answer 2

Important to a moderate degree

Question 3

One of the limitations of using therapeutic alliance measures in counseling settings is:

A) Only observer rating forms have been validated
B) The ones that have been researched are complex and time consuming to complete
C) Clinical norms have not been established
D) They all measure the alliance from only the therapist's perspective

Answer 3

Clinical norms have not been established

Question 4

Which of the following scales uses a visual-spatial response format?

A) California Psychotherapy Alliance Scale
B) Session Rating Scale Version 3.0
C) The Helping Alliance Questionnaire
D) The Visual Alliance Scale

Question 5

All of the following therapeutic alliance scales have parallel client self-report and therapist rater versions except for:

A) Session Rating Scale Version 3.0
B) California Psychotherapy Alliance Scale
C) Helping Alliance Questionnaire
D) Working Alliance Inventory

Question 6

Which of the following therapeutic alliance scales is not based on Bordin's conceptualization of the alliance?

A) Helping Alliance Questionnaire
B) California Psychotherapy Alliance Scale
C) Session Rating Scale Version 3.0
D) None of the above

Question 7

A major limitation of using alliance scales with clients from various racial and ethnic backgrounds is that:

A) Only English language versions exist
B) The alliance is strictly an American concept
C) Clients who have participated in validation studies have been mostly Caucasian
D) They are all based on a Freudian view of the therapy relationship

Question 8

Research has shown that when the counselor and client are of different racial background clients tend to:

A) Give more positive alliance ratings so as not to be perceived as racist
B) Clients' unconscious bias results in them giving more negative alliance ratings
C) It is unclear what clients will do given the lack of research
D) Give similar ratings as they do when counselor and client are of the same racial background

Question 9

An important benefit to using alliance scales or questionnaires is that:

A) Managed care companies require them
B) They have been shown to be predictive of DSM personality disorders
C) They have well established interpretation guidelines
D) Scores obtained early in the counseling process are correlated with client outcomes at the end of counseling

Question 10

When using therapeutic alliance scales it is recommended that counselors:

A) Wait until the relationship have been well established before giving a scale to a client
B) Assess the alliance before the 5^th session
C) Assess the alliance only with clients that may have a personality disorder
D) Not provide feedback to the client unless the client requests it

Question 11

Which of the following therapeutic alliance questionnaires includes a scale to assess a client's ability to self-disclose and reflect on the therapy session?

A) California Psychotherapy Alliance Scale
B) Helping Alliance Questionnaire
C) Working Alliance Questionnaire
D) None of the above

Question 12

A limitation of using the more widely researched alliance questionnaires in counseling settings is that:

A) They are all designated as level C tests
B) They lack adequate construct validity
C) It is unclear what scores are indicative of a problematic alliance
D) They are costly and time consuming to administer

Question 13

Some individuals may respond to alliance questionnaires with a cultural bias that results in:

A) Extremely positive responses
B) Ratings reflecting cultural attitudes about a person of authority and expertise
C) Giving only positive ratings to counselors of the same racial background
D) Female counselors receiving higher alliance ratings than male counselors

Question 14

Research on therapeutic alliance questionnaires suggests that counselors should:

A) Only use alliance questionnaires when using a Person-centered approach
B) Consider using alliance questionnaires early on in the counseling process regardless of the counselor's theoretical approach
C) Use alliance questionnaires in order to predict the degree of symptom improvement a client is likely to have by the 5^th session
D) Rate the alliance themselves, rather than the client rating the alliance

Question 15

Therapeutic alliance questionnaire can assess the degree to which a client:

A) Feels supported and understood and believes she or he is collaborating on counseling goals
B) Has insight about the relationship between childhood trauma and current problems
C) Has a preference towards particular counseling techniques
D) Has developed a negative transference with the counselor

Question 16

What does the term therapeutic alliance mean?

Question 17

Of the alliance measures reviewed in this chapter which one was designed for use by counselors and therapists in clinical practice and what is it about this measure that clinicians would find helpful?

Question 18

What are the benefits and limitations of standardized therapeutic alliance measures?

Question 19

What are some factors to consider when using alliance measures with individuals from non-Western cultures?

Question 20

What are specific research results that would guide the use of alliance measures?