The Historical Evolution and Modern Research of the Alliance in Psychotherapy and Counseling

Abstract

This article presents a narrative review of the development of the concept of the “alliance” in psychotherapy and counseling and its current research trends. The paper describes the change in the perceptions of the alliance — from its perception as neurotic transfer to a separate parameter of relationship, consisting of successful collaboration and trusting interpersonal connection. The most commonly used survey methods for assessing the alliance are reviewed, with psychometric properties provided. The article gives an overview of the use of psycho-physiological and behavioral parameters of the therapist and client as correlates of the alliance. The advantages and disadvantages of objective methods of studying the alliance are discussed. The authors note the relationship between the quality of the alliance in the therapist-client dyads and the degree of interpersonal synchronization of the dyads at different levels during sessions, including measures of oxytocin, the convergence of dyad language styles, and the level of brain-to-brain synchronization. The authors conclude that conducting multi-level, interdisciplinary studies that combine objective and subjective parameters is necessary for the formation of a model of the alliance that includes its cognitive and affective aspects.