PSYCHOTHERAPY: THEORY, RESEARCH AND PRACTICEVOLUME 16, # 3 , FALL, 1979

THE GENERALIZABILITY OF THE PSYCHOANALYTIC CONCEPTOF THE WORKING ALLIANCE1

EDWARD S. BORDIN*University of MichiganAnn Arbor, Michigan

ABSTRACT: The psychoanalytic concept of the work-ing alliance is reviewed and elaborated. It is arguedthat various modes of psychotherapy can be mean-ingfully differentiated in terms of the kinds of workingalliances embedded in them. Moreover, the strength,rather than the kind of working alliance, will prove tobe the major factor in change achieved throughpsychotherapy. Strength of alliance will be a functionof the goodness of fit of the respective personalities ofpatient and therapist to the demands of the workingalliance. Past research bearing on these propositionsand indicated future research are discussed. Exten-sions to changes sought in teaching and other groupprocesses are briefly touched.

Proliferation of psychotherapies has domi-nated the sixties and seventies. Thirty-six psy-chotherapies (Harper, 1959) had to be supple-mented by an additional compilation (Harper,1975). Unchecked, this trend would come peri-lously close to the solipsism, a psychothera-peutic method for each psychotherapist. Notunexpectedly, research in psychotherapy hassuffered from an analogous lack of conver-gence, and with it a disappointing impotenceabout providing empirical tests of competingclaims. As Donald Campbell (1976) suggests,given the wide prevalence of the need for psy-chotherapy, and the continuing ability of indi-viduals or society to pay for it, the winnowingof this harvest of methods must come fromresearch.

Campbell (1976) speaks to the practitioner,exhorting him or her to engage in systematicfollow-up. This essay addresses those prac-

1 An earlier version of this paper was given at the annualmeeting of the Society for Psychotherapy, June, 1975.

* Requests for reprints should be sent to Edward S.Bordin, Ph.D., University of Michigan Counseling Center,1007 East Huron Street, Ann Arbor, Michigan 48109.

titioners who are also research workers, to callattention to a point of view that can encompassmost, if not all, approaches to psychotherapy andcan lead toward the needed convergence in re-search. There has been a promising rate ofgrowth of research and research workers, withencouraging trends toward a coming together onbasic issues: I aim to contribute to that move-ment. Moreover, because of the generalizabilityof my ideas to all change situations, I hope tostimulate research applications to teaching and tocommunity change processes.

1 propose that the working alliance betweenthe person who seeks change and the one whooffers to be a change agent is one of the keys, ifnot the key, to the change process. The workingalliance can be defined and elaborated in termswhich make it universally applicable, and can beshown to be valuable for integrating knowl-edge—particularly for pointing to new researchdirections. As my initial statement suggests, aworking alliance between a person seekingchange and a change agent can occur in manyplaces besides the locale of psychotherapy. Theconcept of the working alliance would seem to beapplicable in the relation between student andteacher, between community action group andleader, and, with only slight extension, betweenchild and parent. While I believe such extensionsto be fruitful, they are beyond the scope of thispaper. I shall confine myself to the therapeuticworking alliance, making only brief inferencesto extensions to other change enterprises.2

2 One might extend the idea of working alliances to non-change situations. Although prisons, under reform ideology,have been set up as change situations, most observationsuggests that staff and inmates typically arrive at a mutuallyagreed-upon alliance to get through their relationship with aslittle upset as possible.

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Four propositions provide a conceptualframework for understanding the differencesamong different theories and approaches to psy-chotherapy, and point the way for converginginvestigations.

1) All genres of psychotherapy have embed-ded working alliances and can be differentiatedmost meaningfully in terms of the kind of work-ing alliance each requires.

2) The effectiveness of a therapy is a functionin part, if not entirely, of the strength of theworking alliance.

3) Different approaches to psychotherapy aremarked by the difference in the demands theymake on patient and therapist.

4) The strength of the working alliance is afunction of the closeness of fit between the de-mands of the particular kind of working allianceand the personal characteristics of patient andtherapist.

THE THERAPEUTIC WORKING ALLIANCEIN DIFFERENT THERAPIES

The terms of the therapeutic working alliancehave their origin in psychoanalytic theory, butcan be stated in forms generalizable to allpsychotherapies. Two foundations of the work-ing alliance are to be found in the psychoanalyticliterature. One of these stems from such views asthose of Sterba (1934) on the alliance betweenanalyst and the rational ego of the patient, and ofMenninger (1958) on the central importance ofthe therapeutic contract. The second draws,among others, on Zetzel (1956) and especiallyon Greenson (1967) for the significance of thereal relationship in psychoanalytic work. Fusingthese contributions, we can speak of the workingalliance as including three features: an agree-ment on goals, an assignment of task or a seriesof tasks, and the development of bonds.

In elaborating on these three aspects, not onlywill I treat them in the context of psychoanalysisor psychoanalytic therapy, but will attempt todemonstrate their application to other forms ofpsychotherapy. Research on the working al-liance should initially be directed at testing theapplicability of these ideas to all varieties ofpsychotherapy.

Agreement on Goals

The ecology of psychological help-seeking is

such that the patient's goals—or at least theground work for goals he agrees on with thetherapist—are commonly laid in the patient'scommerce with other helpers prior to the firstmeeting with the analyst. The significance ofthese prior bargains should not be overlooked.Psychoanalytic (perhaps all psychodynamic)treatment rests on the mutual agreement that thepatient's stresses, frustrations, and dissatisfac-tions are to a significant extent a function of hisown ways of thinking, feeling and acting. Theaim of treatment is to examine, modify orameliorate his or her own contributions to, orexacerbation of, these pains. The circumstancesof life create barriers toward acceptance of such agoal. One could be in such strained economiccircumstances that he is suffering from malnutri-tion, or one may be living under lawless condi-tions, where the malevolence of others is also lifethreatening. No one in these circumstances, evenwithout economic barriers toward enteringpsychoanalysis, could be concerned with a goalwhich concentrated on changing himself, ratherthan on these immediate imperatives of main-taining life. Even persons with less dramatic andless realistic external pressures can be and areconvinced that the sources of their difficulties areexternal to themselves. The early stages ofpsychodynamic modes of therapy are likely to bedevoted to exploring current experience and lifehistory, with the therapist seeking to call atten-tion to ways in which the individual shares re-sponsibility for his unsatisfactory experiences.

My curbstone survey of psychotherapiessuggests that they vary in their emphasis on thecentral and enduring qualities of the goals thatthe therapist defines, either explicitly or im-plicitly3 as those on which he is willing to col-laborate with the patient. Psychodynamic views,especially psychoanalytic views, are directedtoward an enduring core of thought and feelingthat are seen as determining action and experi-ence. Behavior therapists take a divergent posi-tion, doubting the importance, or even the real-ity, of such central cores and, consequently,directing attention and goals to changing specificacts of the individual in commerce with others orwith his physical environment. This situational

3 Social psychologists concerned with group process aretouching on similar negotiations re goals when they speak ofthe hidden agenda of group leader and members.

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specificity not only highlights differences in thedurability of the changes sought, but also showsdifferences in the scope of the person's life thatmight be encompassed by therapeutic goals.These range from the psychoanalytic perspec-tive, which sees the individual functioning in sointegrative a fashion as to encompass all of hisways of thinking, feeling and acting in all situa-tions, to the behavior position which requires nosuch set of encompassing functional relations.Therefore, in behavior therapy, goals are morelikely to be directed toward very specific, some-times narrow, segments of the individual's life.

Tasks

Collaboration between patient and therapistinvolves an agreed-upon contract, which takesinto account some very concrete exchanges. Thepatient must pay for the therapist's skills andefforts. Even more crucial for differences intherapeutic methods are the kinds of tasks as-signed to patient and therapist. We all know thatpsychoanalysis specifies the rule of free associa-tion and seeks to highlight attention to the flow ofinner experience by the technical specificationsof couch, blank screen, and positioning oftherapist away from the patient's center of vis-ion. Behavior therapies and other psycho-dynamic therapies do not insist on attentionto the continuous flow of inner experience, butthey do require honesty in reporting on one'slife and most of them, even some forms of be-havior therapy, require self-observation of innerexperience. The focus of attention varies; itsrequirements are not always the same. In be-havior therapy, because it is concerned with afunctional analysis of a particular set of be-haviors, the patient or an associate may be as-signed the task of observing and tabulating thefrequency and circumstances surrounding a par-ticular action, e.g., assertive behavior. Gestalttherapy, among others, requires attention to ac-tion rather than thought content. I am convinced,as are others, that the effectiveness of such tasksin furthering movement toward the goal willdepend upon the vividness with which thetherapist can link the assigned task to the pa-tient's sense of his difficulties and his wish tochange. (In the teaching enterprise, the recentcry for "relevance" represents a search for ananalogous linking of goal and task.) This set ofassumptions about the change process is impor-

tant, and it is susceptible to empirical verifica-tion. One interesting anomaly in this set of as-sumptions is that there may be modes of ther-apy—client-centered therapy may be one ex-ample—in which tasks are never explicitlyspecified, and only emerge gradually and am-biguously. In many forms of contract manage-ment in behavior therapy, the task assigned is thespecific behavior change sought, with the ex-pectation of positive reinforcements controlledby the therapist or another.4

The tasks assigned the therapist in alternatemethods of psychotherapy also vary. We are allfamiliar with the many ways of designating thesetherapeutic tasks; activity-passivity, empathicunderstanding, communicating, interpreting,self disclosing, etc. These are needed to com-plete the picture of the sort of collaborative effortthat particular varieties of psychotherapy re-quire.

Bonds

The goals set and collaboration specified ap-pear intimately linked to the nature of the humanrelationship between therapist and patient. Forexample, two persons will be more concernedabout liking or disliking each other if they areproposing to settle into a working relationship ofseveral years duration, meeting three or moretimes a week, than if their relationship is ex-pected to terminate in three months or less. Somebasic level of trust surely marks all varieties oftherapeutic relationships, but when attention isdirected toward the more protected recesses ofinner experience, deeper bonds of trust and at-tachment are required and developed. Ourexaminations of such features of therapeuticwork need to be more pointed. For example, thekind of bond developed when a therapist gives apatient a form and asks him to make a dailyrecord of his submissive and assertive acts and ofthe circumstances surrounding them, appearsquite different from the bond developed when atherapist shares his or her feelings with a patient,in order to provide a model, or to provide feed-back on the patient's impact on others. One bondmay not necessarily be stronger than the other,but they do differ in kind.

4 A good example is the treatment of depression by askingand even rehearsing the patient to engage in behaviors de-signed to elicit positive responses from others.

THE WORKING ALLIANCE 255

Another nuance in the therapeutic bond mightbe defined by the difference between a caretakerand a consultant. Some modes of psychotherapyhave much more of a take-charge element builtinto them. Interestingly, two otherwise quitedifferent approaches to psychotherapy, behaviortherapy and psychoanalysis, are similar in con-taining a strong element of taking responsibility,as does rational-emotive therapy. The free as-sociation rule, sometimes implicitly, sometimesexplicitly, asks the patient to replace his atten-tion toward his specific hurts and self-dissatis-factions with a free-floating set, and tells thepatient that the therapist will at least tempor-arily take over the executive functions for him.The exaggerated emphasis on the status of thebehavior scientist clearly casts the behaviortherapist in a major executive role. At the otherextreme, the very ideology of client-centeredtherapy tends to mute the responsibilities of thetherapist and highlight those of the patient.

STRENGTH OF WORKING ALLIANCEAND EFFECTIVENESS

The newness of the idea that the strength ofcollaboration between patient and therapist mayhave more to do with the effectiveness of thetherapy than the particular methods chosen en-sures that there will be little direct evidenceavailable to test the proposition. Using Ryan's(1973) measure of patient collaboration withpsychoanalytically-oriented therapists, Sarnat(1975) found better than chance relations be-tween independently rated levels of collabora-tion and judgments of outcome, as well as theoccurrence of premature termination. Horwitz(1974) reviewed the process and follow-up datain the long-term Menninger Clinic study offorty-two patients, half of whom had beentreated by psychoanalysis, and half by psycho-analytically-oriented psychotherapy. His moststriking conclusion, contrary to expectation, wasthat there were no marked differences in outcomeaccording to treatment mode, but "that a majorcontribution of this study is the indication thatthe therapeutic alliance is not only a prerequisitefor therapeutic work, but often may be the mainvehicle of change." Thus, all of the sources ofdirect data are founded in therapy from apsychoanalytic persuasion. A broader rangingconfirmation would have to depend on the priordemonstration of the applicability of a

generalized measure of the strength of theworking alliance to varieties of psychotherapyand to testing its relationship to outcome in thesevarieties.

There are, however, two lines of inquirywhich provide indirect evidence supporting theproposition that outcome is a function of thestrength of the working alliance. One line ofevidence comes from the work on the influenceof expectations on therapeutic outcome by suchinvestigators as Frank (1961, 1964), Goldstein(1962), Orne (1968), and Strong (1968). Someof these concerns with expectations have treatedthem as subjects for manipulation, e.g., throughartificial attributions of status or expertness to thetherapist. The conceptual framework of theworking alliance, in emphasizing the need forconsensus, directs attention to the process ofreaching agreement, and gives less attention tothe manipulation of expectations (Goldstein,1962; Strong, 1968). It seems certain that bothparties, change seeker and change agent, comewith sets reflecting faith, hope, and experi-ence—in group dynamics parlance they arespoken of as hidden agenda—which must beopenly encountered in the forging of a strongalliance. Frank and his associates at Johns Hop-kins (Frank, 1961; Hoehn-Saric et ai, 1964)have demonstrated the facilitating effects ofOrne's (Orne & Wender, 1968) proposed pat-terns for inducing mutuality of expectations withregard to goals and tasks in individual and grouptherapy. As indicated earlier, the patient's readi-ness to collaborate in a psychodynamicallyoriented goal may be a function not only of hispersonal characteristics, but of the nature of hisenvironmental pressures and supports. I suspectthat the reason Lerner (1972) was able to reportthat her therapists succeeded in psycho-dynamically oriented therapy with lower class,economically deprived patients, was that hersocial-worker therapists owed as much, both in-tellectually and emotionally, to Jane Addams asto Freud. This means that they were first willingto be concerned and involve themselves withtheir patients' "mundane'' problems of keepingalive and achieving minimum creature comfortsbefore turning attention to goals aiming atchanges in their thoughts and feelings.

The other stream of indirect evidence comesfrom the research of client-centered inves-tigators, particularly from Rice and her col-laborators (Rice & Wagstaff, 1967; Rice, 1973;

256 EDWARD BORDIN

Rice & Gaylin, 1973). Their strategy consistedof developing a linguistic measure of client-ex-pressive style, which reflected how thoroughlyhe or she was entering into the self-experiencingtask stipulated as both process and goal in thiskind of therapy. Their research demonstrates thatthose clients who initially exhibit the greatercapacity to respond in that manner are judged tohave improved most. Interestingly, Sarnat(1975) found little overlap between this client-centered measure and a psychoanalytically-oriented measure of client collaboration devel-oped by Ryan (1973). At the same time, bothmeasures showed predictive value for the out-come of psychoanalytically-oriented treatment.But the client-centered measure was only signi-ficant with a number of interviews partially out;the reverse was true for the psychoanalytically-oriented index of collaboration.

In addition, she found that Ryan's measure,unlike the client-centered measure of voice qual-ity, was predictive of whether or not prematuretermination occurred, in itself a reflection ofstrength or weakness of the alliance. These re-sults might suggest that although some elementsof the client-centered alliance do fit psychoanal-ytically-oriented psychotherapy, they do not fitwell enough to forecast either early terminationor the deeper changes achieved in longer termprocesses.

THE PERSONAL DEMANDS OF DIFFERENTWORKING ALLIANCES

The third and fourth propositions deal with thepersonal demands of different working alliancesand strength of the alliance as a function of fit.Since differentiation of the evidence for thesetwo propositions must rest on the design of mea-sures of each type of working alliance and onmeasures of strength to be applied to each, mea-sures largely undeveloped, our review of theavailable evidence will not be readily separatedinto support for one or the other.. Therefore, thereview of available data and research needed willbe discussed under this one heading.

Most of the data for inferring the demands ofworking alliances bear on the characteristics ofthe client or patient. Social class differences inthe treatment that patients receive may, in part,reflect an influence of a combination of situa-tional pressures and psychological sophisticationon the person's readiness to enter into a psycho-

dynamically-oriented alliance. The aforemen-tioned situational orientation of the behaviortherapist is likely to echo the concerns of theeconomically-stressed person and the worldview of less educated persons, thereby makingit easier for such persons to enter into the thera-peutic contract offered by behavior therapists.Indeed, I am inclined to believe the generali-zation that it takes specific acculturation for aperson to accept psychodynamic goals and theconnection between the tasks assigned and theachievement of those goals. The focus on thebody, contained in bioenergetics, may beanother example of goals and tasks that morereadily correspond to the man in the street's levelof understanding, especially the tendency to sub-stitute somatic symptoms for psychological dis-comforts .

The patient's readiness to accept a particulargoal of treatment may turn out to be intimatelylinked to capacities or dispositions, which in turnare related to how easy it is for him to collaboratein the particular mode of treatment directed to-ward that goal. I have already cited the stressesof the patient's life and subculturally-condi-tioned norms for coping actions as two possibleinfluences on the kinds of goals that patients willfind meaningful. When the stresses created byfright about depersonalization, hallucination,delusion or other experiences of being out ofcontrol and out of touch exceed those experi-enced as originating outside the person, he islikely, up to a certain point, to understand andaccept a goal and a method oriented toward hisinner experience.5 But beyond that point, his fearmay be so great as to induce him to flee from sucha confrontation. He can, in fact, only enter into acollaboration designed to deal directly with thefright. The take-charge element in the therapist'spart of the task arrangements may be a vitalfactor in the extremely frightened patient's en-tering into a particular therapeutic collaboration.Ryan (1973) found that indices of hope ascer-tained through independent interviews and levelof development of object relations, as inferredfrom early memories, were related to thestrength of the working alliance manifested at thestart of psychotherapy. This points to the possi-

5 For a review of the complicated, indirect evidence link-ing anxiety and other indices of psychic pain positively withoutcome and negatively with early termination, see Bordin,1974,pp.194-199.

THE WORKING ALLIANCE 257

bility that enduring dispositions play a part in theease with which certain alliances are entered.

Many of the other characteristics required tomeet the demands of various therapeutic tasks,such as psychological-mindedness and prefer-ences for work styles, may also influence thelikelihood that a person will find certain thera-peutic goals meaningful.

Turning attention more fully to the differentialdemands of alternative treatment methods, andthe characteristics of the patient which influencehis ability to comply with the tasks associatedwith that collaboration, I go beyond the trait ofpsychological-mindedness because, while itseems important, it also seems ambiguous.Many of the characteristics I will mention appearto be partial referents of what may be representedby psychological-mindedness as a collectiveterm. As I suggested earlier, virtually allmethods of psychotherapy require the patientto observe her- or himself. The varieties ofpsychodynamic therapies are similar in focusingon the feedback that the person gets from histhoughts, feelings and bodily experience of hisactions, but may, nevertheless, differ. Thus,while all psychodynamic therapies make consid-erable demands for introspection and self-observation, some may make more insistent de-mands for oscillation between observation andaction. Other modes, or other features of thesame therapy, may demand oscillation betweenexperiencing and abstracting and generalizing.Rice and Gaylin (1973) found that those whoresponded to psychotherapy with a turning in-ward of attention and energy and directed it to-ward self-exploration were marked by suchRorschach indices of flexibility and creativity asthe total number of responses, the proportionfeaturing determinants other than form, and thenumber featuring complex organizations. Sarnat(1975) obtained partial replications withinpsychoanalytically oriented therapy.

As I look at various psychodynamic and be-havior-oriented treatment, I find evidence thatthe vividness with which a patient is able torecapture experiences and to create fantasiedones is a requirement for successful treatment.All of these, the vividness of memory and fan-tasy, fullness of self-observation, abstractingand generalizing, and oscillation seem to meready targets for psychological measurement andresearch. Investigation leading to the under-standing and measurement of such processes will

in turn foster more incisive examination of theinteraction between patient characteristics, per-formance in the tasks assigned in psychotherapy,and its outcome.

Research on attrition has already demon-strated a firm connection between performanceon intelligence tests and the likelihood of pre-mature termination. Whether such findings arefunctions of the fact that most of the psycho-therapy under investigation relied on the verbalfacility of the patient for communication, or arefunctions of the more subtle features which linkintellectual and emotional functioning is still tobe proved.

The division of responsibility between thera-pist and patient as a feature of collaborationappears likely to tap into the patient's anxietiesabout dependency, and the ways that he copeswith them. The counter-dependent person islikely to find the client-centered emphasis on hisresponsibility very congenial, at least as a begin-ning. The demystifying elements in behaviortherapy might also appeal to the counter-depen-dent. Yet research by Cairns (1961, 1962) andStewart & Resnick (1970) suggest that counter-dependents are difficult to condition. My ownideas about dependency (Bordin, 1965) suggestthat the relations of the conditions of the workingalliance to anxieties about dependency are likelyto prove complex. I am convinced that thebonding aspects will be particularly importantfrom the very beginning for the overtly depen-dent person but, while possibly interfering atfirst, will be necessary at later stages for thecounter-dependent as well.

Differences in preferred work styles (many ofwhich are intimately related to character forma-tion) might be expected to influence differentialreadiness for varieties of therapeutic collabora-tion. Braat0y (1954) has suggested that hystericswill take more readily than obsessive-compul-sives to an emphasis on body position andmovement, which is so prominent in Gestalt andbioenergetic approaches. Since this suggestioncontradicts Perls' evident conviction that hismethods are particularly valuable as an antidoteto the latter groups' preoccupation with wordsand with intellectualizations, systematic exami-nation of the vicissitudes of attention to the bodywith obsessive-compulsives will be of particularinterest. Tolerance for ambiguity and uncer-tainty would seem to be another fruitful area forinvestigation, and some work on it has been done

258 EDWARD BORDIN

(Bordin, 1966; Schneider, 1953; Temerlin,1956). Here we would need to look at possibledifferences according to whether it is an un-clearly defined task, the wide latitude offered bythe task, or the anonymity of the therapist whichis the source of ambiguity.

The idea that the bonds between patient andtherapist have a significant positive role inpsychotherapy is sufficiently new to leave uswith a relatively undeveloped set of specifica-tions regarding it. In his extremely interestinganalysis of the role of the therapeutic alliance inthe outcome of psychotherapy in the Menningerproject, Horwitz (1974) discusses the patient'scapacities to see the therapist as a good object asan influence toward establishing a strong work-ing alliance. Presumably such capacities are in-timately related to hopeful and trustful states anddispositions. It is extremely likely that we are notjust dealing with static conditions, and it is likelythat these conditions are responsive to the adap-tive responses of the therapist. Horwitz dealswith such alternatives when he speaks of thepossibility that, in particular instances, a moreeffective and stronger working alliance couldhave been achieved through inpatient as com-pared to outpatient treatment.

While there has been some exploration of theinfluence of personal conflicts and neurotic dis-positions on ineffective therapist performance,investigations of the relation of his personalitycharacteristics to the therapist's willingness andability to perform certain tasks, and to the kindsof bonds established, are rarer. There is weakevidence of involvement of Rorschach (Allen,1967; Mueller & Abeles, 1964) and MMPI (Ber-gin & Jasper, 1969; Bergin & Solomon, 1970)indices in empathic sensitivity. The scattered,indirect, and complex evidence bearing on howpersonality factors influence the therapist'sreadiness to like or care for his patient, his will-ingness to disclose his feelings and past experi-ences, and his activity and passivity in therapeu-tic relationships has been reviewed elsewhere(Bordin, 1974) and will not be repeated here.That review reveals the fallowness of theground.

To the extent that psychotherapy is a signifi-cant feature of their life's work, we may assumethat psychotherapists, whatever extrinsic satis-factions they seek, are drawn by the gratifica-tions intrinsic to their work. Current views ofpsychotherapy no longer confine considera-

tion of the therapist's personal satisfactions tothe negative aura of countertransference orother such concepts. This emphasis on positiveinfluences of satisfaction would lead me to ex-pect that differences in working alliances em-bedded in the varieties of psychotherapy will befound to be reflected in personal differences inthe therapists drawn to each variety. These dif-ferences will mirror the kinds of satisfactionsthey might be expected to seek, their preferencesfor work styles, and certainly, their capacities tomeet the demands of the particular kinds of al-liances. Many of the humanistically-orientedpsychotherapies call for much greater self-disclosure. Behavior therapies tend to be lessexplicit, but those that place heavy emphasis onthe therapist as technician would seem to muteself-disclosure. One would infer that the work-ing alliance in such behavior therapies placedlighter demands on therapist empathic skills,since attention is directed toward overt behaviorrather than the covert processes of thought andfeelings. Yet the recent (as yet unpublished) re-search by Sloane, reported by Bergin & Suinn(1975), produced evidence that three behaviortherapists received higher empathy ratings thanthree analysts, all of whom were involved in acomparative study. I leave this seeming anomalyto future investigators. What enduring resultshave come out of research on the A-B scale, as anindex of differential effectiveness with schizo-phrenic patients, derive, I am certain, from thefact that the scale is founded in a set of responsesthat have been shown to be functionally relatedto vocational choice (Chartier, 1971; Razin,1971).

The perspective of the working alliance leadsme to the conclusion that the matching of thetherapist and patient in terms of personality willbe most precisely understood in terms of themediating effects of the demands of that workingalliance, which simultaneously meets the needsof patient and therapist. Whether, for example,similarity or complementarity is to be expectedwill depend on the relations of the demands onthe patient to those on the therapist and how wellfitted each is by that particular alliance.6

6 Though not interpreted in working alliance terms, theresearch of Mann and his collaborators (Mann et al., 1970)on the influence of the interaction of teachers' and students'styles on the classroom process would be an example of itsapplication to the teaching-learning situation.

THE WORKING ALLIANCE 259

A NEW IMPETUS TO ASSESSMENT

AND DIAGNOSIS

In recent years there has been a marked disaf-fection with assessment and diagnosis amongthose immersed in psychotherapy, perhaps mostevident among psychologists. There are un-doubtedly many reasons for this development:aversions to static designations, concern overthreats to civil rights associated with somelabels, etc. Psychologists, whose discipline wasmost involved with the development and valida-tion of various devices and procedures for per-sonality assessment, were demoralized by muchnegative evidence on the validity of thesemethods and lost interest; also because suchmethods did not seem, on the face of it, of anyuse in making treatment decisions.

I believe that I have shown that the applicationof the terms of the working alliance leads tomuch more specific formulations about the func-tion of specific personal characteristics of bothpatient and therapist. I am hoping that thisgreater specification will provide a source ofguidance and inspiration to the personalogistsamong us to stimulate a renewed effort at inves-tigating these personal characteristics so that wecan understand them, and through that under-standing discover more efficient and pointedmethods of assessing them.

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