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Open Access Thesis

Document Type


Degree Program


Degree Type

Master of Science (M.S.)

Year Degree Awarded


Month Degree Awarded



The therapeutic alliance is an empirically-supported element of successful psychotherapy. However, the degree to which training programs incorporate alliance-centered components into their curricula and clinical practica remains unclear. The aims of this study were to (a) examine training programs’ awareness of alliance research; (b) determine the extent to which programs incorporate formal, evidence-based alliance training into their pedagogy; (c) determine whether there are differences in evidence-based alliance training practices between programs with different foci/terminal degrees and programs with different training models; and (d) cultivate an understanding of what training programs would consider ideal alliance training practices and the barriers that may interfere with them. Data derived from a quantitative survey of directors (or their designates) of APA-accredited clinical and counseling doctoral programs in the United States and Canada and a follow-up qualitative survey that examined participant reactions to the initial survey results. Generally, respondents indicated that their programs were aware of alliance research trends. However, respondents also largely indicated they do not incorporate systematic, evidence-based alliance training into their programs despite believing that such systematic elements would contribute to ideal alliance training practices. There were no statistically significant differences between graduate program degree type and training model in terms of awareness of alliance research or current alliance training practices. However, differences in views on gold-standard training emerged for training model; practitioner-scholar programs endorsed greater preferences for systematic alliance training relative to clinical scientist and scientist-practitioner programs. Qualitative responses to the findings provide additional context, and implications for training and future research directions are discussed.


First Advisor

Michael J. Constantino