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Open Access

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Master of Science (M.S.)

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Month Degree Awarded



First session, therapeutic alliance, psychotherapy


Although the therapeutic alliance is known to be a principal therapeutic factor, little attention has focused on therapists’ perspectives on the impact of the first session on the development of the therapeutic alliance. The present study is a qualitative exploration of interviews with ten therapists regarding the first session and their efforts to establish a therapeutic alliance with their new clients. The data were analyzed using Clara Hill’s Consensual Qualitative Research paradigm (CQR). In considering Bordin’s (1979) three components of the alliance (tasks, goals, bond), therapists viewed the bond as the most influential contributor to the development of the alliance in the first session. The therapists emphasized being attuned to the client, being honest and open, generating curiosity, gently challenging, and setting the frame and expectations for therapy as important actions to take when working to establish an alliance in the first session. The findings from this study contribute to the literature on the therapeutic alliance, with particular attention to strategies for facilitating alliance development from the outset of therapy.


First Advisor

Richard P. Halgin