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Research on the alliance has mainly focused between-patient data (e.g., how differences in alliance among patients are related to outcome for a patient compared to other patients). However, this level of analysis partly misses its target because psychotherapy theories and therapists focus primarily on within-patient processes (e.g., whether change in a client’s alliance during the course of therapy may lead to a reduction of symptoms in that client). So far, the ability to separate these effects has not been fully capitalized upon in alliance research. Notable exceptions are the studies of Tasca and Lampard [1] and Falkenstrom et al. [2] and our own study Hoffart et al. [3]. The purpose of the present short communication is to present and discuss these studies, with particular emphasis on our own study.

The Need to Study Within-Person Processes in Psychotherapy: A Discussion of Alliance Studies