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Psychother Res. 2009 Nov;19(6):687-98. doi: 10.1080/10503300902933170.

Stages of change and the working alliance in psychotherapy.

Author information

  • 1Department of Educational Psychology, University of Alberta, 1-135 Education North, Edmonton, Alberta, T6G 2G5, Canada. mee@ualberta.ca


This study investigated whether the working alliance mediates between the stages of change and symptom improvement. It also investigated whether progression to a higher stage of change was associated with an enhancement in working alliance and outcome scores. Fifty-six adult clients receiving counseling at a community mental health clinic completed measures after the first, fifth, and termination sessions. Using the Baron and Kenny (1986) and bootstrapping procedures, the working alliance was found to be a mediating variable. A multivariate analysis of variance indicated that clients who progressed from a lower stage to a higher stage reported stronger working alliances and more symptom improvement than those who did not progress. These results offer further support for the importance of a strong working alliance in psychotherapy.

[PubMed - indexed for MEDLINE]
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