When is it Effective to Focus on the Alliance? Analysis of a Within-Client Moderator

Sigal Zilcha-Mano, Ilana Lipsitz, Paula Errázuriz

Research output: Contribution to journalArticlepeer-review


Contemporary studies on the working alliance seek to move forward from demonstrating an association between alliance and outcome to investigating how alliance can be used to maximize treatment outcome by identifying the clients for whom state-like changes in alliance predict symptomatic change (between-clients moderators). Yet, very little is known empirically on when state-like changes in alliance predict outcome for individual clients (within-client moderators). The present study, based on a sample of 327 clients, demonstrates that state-like changes in alliance at a given session have a significant effect on subsequent session outcome only in the case of higher life satisfaction in that session. This finding suggests that strengthening in the state-like component of the alliance has a greater effect on outcome when the client suffers less from poor life satisfaction.

Original languageEnglish
Pages (from-to)159-171
Number of pages13
JournalCognitive Therapy and Research
Issue number2
StatePublished - 1 Apr 2018

Bibliographical note

Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.


  • Alliance
  • Alliance-outcome association
  • Process psychotherapy research
  • Within-client moderators

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology


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