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An Overview of The Working Alliance Amanda Mitchell University of Calgary

!"##$#%&'()*+&,-!./01&233/2045& An Overview of The Working Alliance The working alliance has been one of the most well researched topics in

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counselling psychology. This paper will focus on reviewing the literature on the working alliance, a discussion on my personal integration of the working alliance in my own practice, and the need for counsellors to address variables in the alliance. Finally this paper will conclude with a discussion on how the microskills model contributes to the working alliance. Review of the Working Alliance Literature What is The Working Alliance? Hiebert (2001) explains that the working alliance is comprised of three facets: (a) A trusting relationship, (b) agreement on tasks, and (c) agreement on goals. The working alliance can also be described as, . . . collaboration between the client and the helper based on their agreement on the goals and tasks of counselling (Egan, 2007, p. 49). In this context the tasks are defined as what the client needs to do to achieve his or her goals and what the therapist needs to do in order to best facilitate success (Baylis, Collins, & Coleman, 2011). A strong working alliance encourages the client to explore cognition and affect, and feel safe enough to risk disclosing information to the therapist (Hiebert, 2001). Furthermore, by agreeing on tasks and goals the client and therapist are more likely to take ownership and feel a sense of accomplishment upon completion of these goals (Hiebert, 2001). Having a trusting relationship is central to counselling and is based on the therapists ability to empathize, use microskills, and display a nonjudgmental attitude (Egan, 2007).

!"##$#%&'()*+&,-!./01&233/2045& Upon review of the literature dedicated to the working alliance, it is easy to see that this topic has played a major role in the research and development of counselling

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psychology. Everyone seems to have an opinion when it comes to the working alliance, whether it be Ellis (2004) claiming that it should not be overplayed or Carl Rogers (1957) emphasizing that nothing is more important than the alliance. The overall consensus is that the working alliance is important and some even go as far to say that counselling without considering the alliance is unethical (Castonguay, Constantino, & Holtforth, 2007). History Looking back through the history of the working alliance is important as it gives us insight into the formation of counselling psychology. Even though the term working alliance was not coined until 1965 by Greenson, it has been a topic of interest since the time of Freud (Baylis et al.; Egan, 2007). Freud believed that having a strong working alliance gave the therapist authority which helped to strengthen the clients trust in him or her thus making it easier to deal with freshly exposed personal trauma. The client, therefore, would project feelings they had towards another authority figure in their life onto the therapist (Horvath, 2000). Freud also emphasized that the therapist should display sympathetic understanding of what the client was saying to increase this bond (Horvath, 1993). The transference of the client viewing the therapist as an authority figure would give the client even more confidence in the therapist and therefore reveal more to him or her. Freud later modified this position to include a therapeutic relationship based in reality. The ability of the intact portion of the clients conscious, reality-based self to develop a covenant with the real therapist makes it possible to

!"##$#%&'()*+&,-!./01&233/2045& undertake the task of healing (Horvath, 1993, p. 562). As time went on more and more theorists began writing about the working alliance and many came to the conclusion that it was the task of the therapist to provide an environment based on trust and compassion where the client can explore issues and any discrepancies in their thinking and behavior (Horvath, 1993). The debate of how transference plays into the therapeutic alliance continues on today with some theorists emphasizing the importance of transference and others downplaying its role. In the 1940s and 1950s Carl Rogers brought a renewed interest in the working alliance with his declaration that nothing is more important than the alliance between therapist and client. Rogerss (1946, 1957) contributed to the popularity of the working

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alliance when he stated that if the therapist is empathetic, practices unconditional positive regard, and if there is congruence in the relationship then change will happen on its own. Rogers (1957) went on to say that no other conditions must exist to bring about change other than unconditional positive regard, empathy, and congruence. Rogers believed that the it was the relationship offered by the therapist, not the techniques used, that mattered when guiding a client through change (Horvath, 2000). Rogers emphasized that as long as the conditions mentioned above remain intact, change will come about on its own and that the therapist must remain patient and have confidence in the process (Rogers, 1946). Rogers (1946) said that the client will become motivated, explore his or her own attitudes and beliefs, gain self awareness, accept him or herself, make realistic goals, and will live life with more harmony. Rogers said, If the client feels that he is actually communicating his present attitudes, superficial, confused, or conflicted as they may be,

!"##$#%&'()*+&,-!./01&233/2045& and that his communication is understood rather than evaluated . . . then he is freed to communicate more deeply (Rogers, 1946, p. 419). Measuring the Working Alliance Because research has shown that the quality of the working alliance is an excellent determinant of the outcome of therapy, it is important to know how it can be measured so as to be able to better predict the outcome (Bachelor, 1995; Bedi, Davis, & Williams, 2005). The ways in which the alliance can be measured have varied over the years, however some researchers such as Bachelor and Bedi et al. have been able to categorize some of the therapist variables that clients see as important to create and maintain a strong working alliance. Bachelor explains that because the clients opinion of the working alliance is the opinion that matters the most, researchers should focus on what the client views as important. Bachelors study, for example, focused on asking

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clients to provide their perspective on what makes a quality working relationship and was able to break the characteristics down into three groups: Nurturing, Insight-Oriented, and Collaborative. Furthermore, Horvath (2000) states that although the alliance can be

measured by the therapist, the client, or an observer; the clients perspective far outweighs the other two. Horvath also states that when asked to measure the rapport between themselves and their therapist, the client will consider not only their therapeutic experience but will also consider the therapists individual characteristics which will be explored further in the next section. Therapists, unfortunately, are known for providing the least accurate assessment of the working alliance, often over estimating its strength (Horvath, 2000). This lack of insight can lead the therapist to misunderstand the needs of

!"##$#%&'()*+&,-!./01&233/2045& the client and may lead to a rupture (Hersoug, Hoglend, Havik, von der Lippe, & Monsen, 2009). Therapist Characteristics and Strengthening the Working Alliance Having a strong working alliance has been proven to increase the chances for a positive outcome in therapy and has even been called the key to successful therapy no matter the modality used (Baylis et al., 2001; Horvath, 2000). Furthermore, there is an overall consensus amongst writers that the quality of the therapeutic alliance depends on the therapist characteristics and techniques as well as the clients characteristics

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(Castonguay, et al; Egan, 2007). Bordin (1979) explains that the strength of the working alliance will depend on the fit of the characteristics between the therapist and client. In other words, therapy is a two way street that requires active participation from both the client and the therapist in order to facilitate the best possible outcome of therapy (Egan, 2007). Castonguay et al. explain that in order to achieve the best therapeutic results the client needs to have a desire for change, ready to work and face challenges, and have a healthy mind. Meanwhile the therapist should be flexible, self aware, warm, nurturing, insightful, patient, compassionate, empathic, open, and honest (Hersoug et al). The same study showed that characteristics such as rigidity, uncertainty, tense, distant, and distract set the therapist up for developing a negative working alliance. In order to increase the clients compliance to treatment, Ruglass and Safran (1992) explain that through a social influence process, the client will develop a positive association with therapy and be more likely to actively participate if the therapist is warm, empathetic, and genuine. In other words, if the client enjoys being with the therapist, he or she will enjoy the process of therapy more and will therefore be more likely to put in the work required. The therapist

!"##$#%&'()*+&,-!./01&233/2045& is ultimately giving the client hope for success.

<& This is consistent with Greensons idea

that there should be a sense of mutual liking between the therapist and the client (Ruglass & Safran, 1992). Another consideration is what Bachelor (1995) found in her study of having clients provide feedback on what they found helpful in establishing a good working relationship and increasing self-disclosure. Clients identified three areas of characteristics that counsellors may have that help strengthen the working alliance: nurturing, insight, and collaborative alliances. By breaking down the characteristics into three groups, Bachelors (1995) study matched up with what other researchers were already saying. Nurturing therapists were seen as respectful, non judgmental, empathic, understanding, and created a warm and inviting atmosphere. Insight-oriented therapists provided clients with understanding of him or herself and helped them dig deeper into what brought them to therapy. These clients were able to trust their therapists and were able to develop self-awareness. Finally, therapists who fall under the category of being collaborative are seen as actively involving the client in the process of therapy and in the creation of tasks and goals. This fits in perfectly with what Hiebert (2001) said about the client and therapist agreeing on goals and tasks in order to have a working alliance. Once again, this sort of relationship is based firmly on trust and respect. Therapeutic Rupture Even the best therapists will experience a rupture in the therapeutic relationship and must respond to it appropriately. A rupture can be defined as the deterioration of the relationship between the therapist and the client (Safran & Muran, 1996). As mentioned earlier, the quality of the working alliance is often a good predictor of the outcome of

!"##$#%&'()*+&,-!./01&233/2045& therapy whether it is positive or negative (Horvath, 2000). Bedi et al., 2005, however, found that the clients perspective of the working alliance often differs from the therapists, leaving the therapist oblivious to a possible upcoming rupture. Ruptures can occur under many different circumstances including, but not limited, to a miscommunication, breach of trust, or the therapists personal issues. Many therapists have a difficult time recognizing when a rupture has occurred either because they fail to read their client, or they are not self aware (Safran et al., 2001). Moreover, according to Safran et al. many clients do not feel comfortable in expressing their frustration with the

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therapist and will often fail to mention it. If the client feels there is a lack of trust then he or she is likely to terminate therapy (Horvath, 2000; Safran et al.). When a rupture does occur, it is vital the therapist respond to it appropriately in order to not only preserve the therapeutic relationship but to also use it to improve the rapport and as a learning opportunity (Safran & Muran, 1996). It is a very human reaction to respond to criticism in a defensive manner, and therapists are no exceptions to this tendency. Unfortunately this type of response is often detrimental to therapy and may result in the therapist becoming rigid or even blaming the client for the problem (Safran et al.). Furthermore, the response of the therapist may confirm the clients unhealthy belief systems. For example, if a therapist responds to a client who is very apprehensive by distancing him or herself or giving up then he may have confirmed the clients belief that no one wants to get to know me (Safran & Muran, 1996). By systematically exploring, understanding, and resolving alliance ruptures, the therapist can provide patients with a new constructive interpersonal experience that will modify their maladaptive interpersonal schemas (Safran & Muran, 1996, p. 447).

!"##$#%&'()*+&,-!./01&233/2045& Integrating the Working Alliance in my own Practice Tying in History with my Practice My approach to therapy is mostly client centered with a small amount of cognitive behaviour therapy. I see the therapist as a guide in helping clients reach their goals of change but the client as always in charge of where they want to go. Because of this viewpoint I have taken to heart what Rogers (1946) said about providing

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unconditional positive regard, congruence, and empathy being the most important part of therapy. These facets are very important for developing a rapport between the therapist and client, which is central to creating a working alliance. Rogers (1946) believed that everyone has the desire to actualize and essentially be all you can be. This is another facet of his work that I try to practice, especially because I see it as important to establishing rapport. Rogers (1946) believed in the importance of being genuine when working with clients and that by doing so the client will begin to trust their therapist. When meeting with a client for the first time I try to clear my mind of any judgments or prejudice that may come up. This is particularly important when working with mandated clients since often I hear about their stories before even meeting them. This also fits in with what Hersoug et al. say about clients picking up on hostility or warmth and responding to how they are treated and perceived. Historically the working alliance has not been seen as necessary in cognitive behaviour therapy, however, researchers have found that establishing a good working relationship will help to facilitate the success of CBT strategies (Ruglass & Safran, 1992). This fits in well with my approach as I prefer to establish a bond by using a client centered approach prior to challenging thinking patterns and irrationalities. The idea

!"##$#%&'()*+&,-!./01&233/2045& here is that the therapist and patient form an alliance around the task of examining the validity of the patients thoughts and beliefs in a scientific fashion (Ruglass & Safran, 1992, p. 406). Studies have also shown, for example, that if a client has issues with

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abandonment, those irrational thoughts may be challenged by having a therapist who is empathetic and provides unconditional positive regard which proves that the relationship in itself can actually be a tool for facilitating client change (Ruglass & Safran, 1992). Further research has also proven that the working alliance is important across all modalities and can predict the outcome of therapy no matter what technical skills are used (Baylis, Collins, & Coleman, 2011). Bachelors Study and Therapist Qualities In Bachelors (1995) study of how the client perceives the working alliance and therapist qualities, I identified strongly with wanting to maintain a nurturing atmosphere in sessions. Nurture in this context refers to the therapist as being trustworthy, respectful, non judgmental, empathetic, understanding, patient, and listening attentively (Bachelor, 1995). I also strive to create an atmosphere that is friendly and welcoming to clients by setting up my office to include a choice of seating that is not obstructed by a table, plants, calm paintings, and a white board where I often write inspirational quotations. This theme goes along with what Bachelor (1995) says about many clients desiring a friendly and welcoming atmosphere, especially at the beginning of therapy. It was the feeling of being at ease and comfortable with ones therapist, which was generated by one or more of these characteristics [friendly, trustworthy, compassionate], that promoted selfdisclosure (Bachelor, 1995, p. 328). I also try to use skills that will foster this nurturing atmosphere by reflecting meaning and affect which Hiebert (2001) explains will help the

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client know that I understand what they are saying and am tuned in. Reflecting affect also is a good way to develop empathy with clients and show them you understand how they feel (Hiebert, 2001, p. 13). These skills correspond well with showing compassion, attentively listening, and understanding. I also use descriptive praise as a way to encourage my clients to keep going and let them know that I see the good in them which will help build trust (Hiebert, 2001). For example, if a client reaches a goal of not using alcohol to cope with a stressful situation, I may say, You were effectively able to manage the situation without using alcohol and found healthier ways of coping. Working with Mandated Clients Another reason why I focus on providing a nurturing environment is because approximately 50% of my clients are court mandated to therapy. Many of these clients are very hesitant to seek counselling and are apprehensive about confidentiality. In my experience, once a client begins to trust me that I am not reporting back to their probation officer without their permission, I find they open up and begin to talk more. This is consistent with what Horvath (2000) says about increasing compliance with therapy by creating an environment that is safe and free from judgment. When considering clients who are mandated to therapy, I relate their experience to Bedi et al.s (2006) study on critical incidents and the formation of the therapeutic alliance. This study was able to identify the importance of setting the tone for the session from the first handshake to the farewell. Bedi et al. found that even simple things such as greeting the client by name and with a smile, allowing the client to choose where to sit, and opening the door for them increased the therapeutic alliance. These small steps, in my opinion, can go a long way in helping a client feel more at ease, especially if they are unfamiliar with therapy.

!"##$#%&'()*+&,-!./01&233/2045& Often I try to build my empathy by picturing myself entering an addictions office and considering how I would feel. What comes to my mind immediately is wondering and

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worrying about confidentiality, especially in a small town where it is very common to see clients on the street. Unfortunately addictions and mental health still carry a large stigma and I believe counsellors should do everything possible to make their clients feel more comfortable. Collaboration and Flexibility Because every client is different, I try to modify my approach to best suite the individual needs that come up. As previously discussed, Bachelors (1995) study also showed that many clients respond well to having a collaborative alliance. Collaboration is also consistent with Rogerss (1946) emphasis on congruence and the need to agree on tasks and goals in a working alliance (Hiebert, 2001). A collaborative alliance, according to Bachelor (1995), means the client feels actively involved in the therapeutic work. The collaborative-type client acknowledged or recognized that the work of therapy and positive change was not exclusively the therapists responsibility and that each partner participates in and contributes, although differently, to the therapeutic undertaking (Bachelor, 1995, pp. 328-329). I try to create an atmosphere of collaboration right from the beginning by asking the client to identify goals, working together to establish tasks, and by emphasizing that the client is the expert on him or herself (Hiebert, 2001). In my experience, this gives the client power and helps them to take ownership and responsibility of what they want to get out of therapy (Hiebert, 2001). Handling a Therapeutic Rupture

!"##$#%&'()*+&,-!./01&233/2045& As mentioned in the previous section, therapeutic ruptures are part of every therapists career and is something that should be planned for. As Safran et al. explain

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that the manner in which the therapist handles a rupture can help repair the relationship, or lead to its destruction. Because I am new to the field of counselling, I find it intimidating to think that even experienced therapists often misinterpret their clients which can easily lead to a rupture (Safran et al.). I do, however, maintain the philosophy that how a person responds to a mistake is often more important than the mistake itself. Also as Safran et al. say, many therapists become defensive when clients are brave enough to discuss their dissatisfaction with therapy. One thing I try to practice is selfawareness and taking an inventory of how I am responding to clients and to know my own signs that I am becoming defensive. Hopefully this increase of awareness will help me to be honest with myself, and the client, and allow me to respond non-defensively which often will save the relationship (Safran et al.). Horvath on Therapists Variables Another facet to take into consideration with establishing the working alliance is the therapists variables as discussed by Horvath (2000). Horvath describes that both the therapist and the client bring a history of personal interactions, social skills and attachment styles. All of these variables have a part to play in what the therapeutic alliance will look like. These variables for the therapist will also contribute to the style he or she uses whether it be nurturing or analytical. Hersoug et al. also suggest that therapists who grew up in a warm and nurturing environment will be more likely to empathize with and have compassion for their clients which facilitates a better working alliance. Thankfully one of my personal strengths is that I am very comfortable

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interacting with people and feel at ease in working in groups and am not afraid to speak up in a crowd. Hersoug et al. also emphasize that a therapist with these abilities will help clients feel more open to sharing and will be more successful in drawing out information from clients. Furthermore, the therapists variables will affect the skills chosen and the clients variables will affect how he or she wishes to tackle the issue at hand (Horvath, 2000). All of these variables will impact the formation and maintenance of the therapeutic alliance. For example, for a client who has difficulty forming trusting relationship outside of therapy, he or she will most likely continue to have problems trusting a therapist. Because therapists are just as human as their clients, they too bring a backlog of personal history that may impact the working alliance. Horvath (2000) goes on to explain that research has shown that therapists who have unresolved relationship issues may not be able to effectively form a bond with some clients, regardless of their training. Therapists need to be self-aware of how their past affects their current work life and never underestimate the power our history may hold on the counsellors impact to work effectively. . . . The alliance reflects a true or real relationship predicated on the specific characteristics and behaviours of the participants (Horvath, 2000, p. 172). Hersoug et al. go on to explain that therapists who have unresolved hostility or bitterness may actually project that negativity onto their clients who in turn will have a negative therapeutic experience. The importance of self care is something that I take very seriously so as to avoid a situation like this. I believe that all therapists should engage in counselling on a regular basis, consult with coworkers, and de brief with a supervisor after a tough session. As I stated earlier, we are all human and need to take care of ourselves.

!"##$#%&'()*+&,-!./01&233/2045& When discussing how my personal variables play into the working alliance, I

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know there are several things I need to consider. As already discussed, I try to provide a nurturing atmosphere for my clients which includes friendliness, attentiveness, and understanding (Bachelor, 1995). Because these qualities come to me more naturally than providing insight, Ive chosen to use these strengths in the work I do. This is consistent with what Horvath (2000) says about both the client and the therapist bringing unique characteristics and predispositions that will predispose them to choose certain styles of interaction, whether that be nurturing, collaborative or insight-oriented. Horvath (2000) also explains that these predispositions are based on social skills, attachment styles, and their own history. Simply put, a persons personality will attract them to different ways of interacting with other people. It is my belief that therapists should be self-aware about their own style of communicating so that they can focus on working with their strengths when providing therapy. Also contributing to the working alliance are the therapists technical skills and abilities in leading a therapy session as well as the clients understanding of the problem (Horvath, 2000). In summary, the therapists technical skills and interpersonal dispositions mixed with the clients interpersonal dispositions will determine the quality of the working alliance. Microskills and the Working Alliance As previously mentioned, the working alliance is comprised of three areas: mutual trust between the client and therapist, collaboration on goals, and collaboration on tasks to meet said goals (Hiebert, 2001). In order to build the working alliance, the therapist can make use of microskills aimed at improving rapport, efficiency, and understanding. Microskills can be divided into four sections: Skills for Enhacing Meaningfulness, Skills

!"##$#%&'()*+&,-!./01&233/2045& for Engaging People, Skills for Clarifying and Providing Feedback, and Skills for Attending (Hiebert, 2001). Skills for Enhancing Meaningfulness

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As the title alludes to, the skills for enhancing meaningfulness strive to enhance the meaningfulness of a session by creating order and organization. Summarizing, over viewing, reviewing, goal setting, transitioning, and information giving all fall under this category (Hiebert, 2001). Evans, Hearn, Uhlemann, and Ivey (2004) give the example of using a summary to help the client organize his or her thoughts and provide a bottom line for themes throughout their story. According to Egan (2007) some of the best times to use a summary are at the beginning of a new session especially if clients are hesitant or not sure where to start, during a session that is going nowhere, and when the client needs a different perspective. Summarizing during these times will provide clarity and direction for the client and encourage them to keep talking and identify what is important to them. Furthermore, skills for enhancing meaningfulness can help clients tie together scattered elements of their story and give them clarity and understanding of the issue at hand (Egan, 2007). These skills help clients see their issues from a birds eye view and encourages them to become mindful of patterns that emerge in their lives. Engagement Skills Engagement skills include open and closed questions, declarative probes, prompting, demonstrating, and describing inconsistencies. The purpose of these skills is to increase client involvement and give the client an opportunity to express their experiences in their own words (Hiebert, 2001). Using open ended questions, for example, encourages the client to consider their answer beyond a simple yes or no, and

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gives them the chance to participate more in the session (Egan, 2007). The use of skills such as open ended questions or probes can also help ensure the therapist is not dominating the conversation, but that the client is speaking at least half the time. Egan (2007) explains that the use of engagement skills also gives the client a chance to practice communication skills and encourages them to dive deeper into the issue at hand. The use of engagement skills can also prevent the therapist from giving advice that is not solicited or misunderstanding the client (Egan, 2007). Furthermore, by giving the client the chance to use their own words, the therapist is setting the client up to succeed by taking ownership of his or her words, thoughts, and goals. Engagement skills also encourage clients to give more information, engage deeper in the conversation, and are often perceived as non-threatening which will help increase rapport (Evans et al., 2004). Because engagement skills help the client engage in the dialogue of therapy, they tend to be useful when working with clients who are shy or resistant to therapy in general. Hiebert (2001) also explains that engagement skills such as open questions can reduce bias and encourage the client to view situations from different points of view. Using engagement skills can also give the client ample opportunity to speak and minimize the risk of the therapist talking too much (Egan, 2007). Skills for Clarifying and Providing Feedback Skills for clarifying and providing feedback, also known as reacting skills, exist to provide the client with information, build relationships, enhance rapport, and clarify uncertainties (Hiebert, 2001). Examples of reacting skills include: Reflecting Meaning, Reflecting Affect, Descriptive Praise, and Correctional Feedback. Providing reflections for the client is an excellent way for a therapist to let his or her client know that their

!"##$#%&'()*+&,-!./01&233/2045& therapist understands what they are saying and where they are coming from (Hiebert,

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2001). Reflecting meaning can also clear up misunderstandings and clarify the point the client is trying to make. These skills greatly help increase rapport between the client and therapist, which is vital to building a strong working alliance. An example of reflecting affect is if a client says, There is just so much happening in my life right now, its hard to describe. The therapist may respond with, Youre feeling overwhelmed with life right now. The use of reflections let the client know you empathize with them and understand their point of view. Empathy can be a very powerful tool for developing the working alliance as it fosters compassion, understanding, and trust (Egan, 2007). According to Egan (2007) empathic reflections can be one of the toughest skills to master and also one of the most important for developing a working alliance. Accurately reflecting a clients thoughts or feelings can help move the session deeper and encourages the client to keep digging. This means identifying key emotions the client either expresses or discusses . . . and weaving them into the dialogue . . . (Egan, 2007, p. 104). Skills for Attending Finally, skills for attending include paraphrasing and non-verbal listening skills including the therapists body language. Once again, using skills such as paraphrasing lets the client know the therapist is tuned in and paying attention (Hiebert, 2001). Paraphrasing, however, may always be appropriate since it does not add anything new to the conversation or facilitate further exploration. The client may not see a new point of view when the therapist paraphrases what they are saying (Hiebert, 2001). Nonverbal listening skills include body language and the manner in which the therapist portrays him or herself and can help set a calm and welcoming atmosphere (Hiebert, 2001). Egan

!"##$#%&'()*+&,-!./01&233/2045& (2007) explains that nonverbal behaviours can help set the tone for conversations, can communicate emotions, change verbal messages, and provide clues about what the therapist or client is not saying. Facial expressions and body posture in particular can

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give away clues for when a person is uncomfortable, unsure, or angry. Egan (2007) goes on to explain that learning how to read a persons nonverbal language is an important skill for therapists to develop in order to better understand their clients. Effective helpers learn this language and how to use it effectively in their interactions with their clients (Egan, 2007, p. 74). Body language can also give clients clues as to how tuned in their therapist is. Therapists who sit with their arms folded and turned away may be telling their clients they are not interested in them and will take away from the therapeutic relationship (Egan, 2007). Furthermore, inattention to body language can lead to an atmosphere of distrust and resentment, further impeding the alliance. Egan (2007) also emphasizes that therapists can learn a lot from themselves just by paying attention to their body language. Often our emotions are portrayed physically, sometimes even before we are aware of how we are feeling. For example, if a therapist is working with a client and she feels herself clenching her jaw, this may be a signal that she is becoming angry or annoyed and she needs to assess in herself what is causing this reaction. Hiebert (2001) suggests using the acronym SOLER to build good body language habits. The breakdown of SOLER is: Sit squarely, Open arms, Lean slightly forwards, Eye contact, and Relax. Therapists who follow these guidelines and who are genuine in their compassion for their clients will create an open and welcoming atmosphere where clients feel at ease to discuss what is on their hearts and minds. Conclusion

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In conclusion, the working alliance is a topic that has been studied for many years and will continue to be at the center of research in the world of counselling psychology. The working alliance is key to helping clients reach their goals and is an excellent tool for predicting the outcome of therapy (Hiebert, 2001). The working alliance is something that should not be taken lightly, but should be treated with respect so that we as therapists can best do our work of helping clients achieve change. & & & & & & & & & & & & & &

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References Bachelor, A. (1995). Clients' perception of the therapeutic alliance: A qualitative analysis. Journal of Counseling Psychology, 42(3), 323-337. doi:10.1037/00220167.42.3.323 Baylis, P., Collins, D., & Coleman, H. (2011). Child alliance process theory: A qualitative study of a child centred therapeutic alliance. Child and Adolescent Social Work, 28(1), 79-95. doi:10.1007/s10560-011-0224-2 Bedi, R., Davis, M., & Williams, M. (2005). Critical incidents in the formation of the therapeutic alliance from the client's perspective. Psychotherapy: Theory, Research, Practice, Training, 42(3), 311-323. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.ucalgary.ca/ Bordin, E. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, Practice, Training, 16(3), 252-260. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.ucalgary.ca/sp3.4.1b/ovidweb.cgi Castonguay, L., Constantino, M., & Holtforth, M. (2006). The working alliance: Where are we and where should we go? Psychotherapy: Theory, Research, Practice, Training, 43(3), 271-279. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.ucalgary.ca/sp-3.4.1b/ovidweb.cgi Egan, G. (2007). The skilled helper (8th ed.). Belmont, California: Thomson

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Brooks/Cole. Ellis, A. (2004). Why rational emotive behavior therapy is the most comprehensive and effective form of behavior therapy. Journal of Rational-Emotive & CognitiveBehavior Therapy, 22(2), 85-92. Retrieved from Human Sciences Press, Inc. Evans, D., Hearn, M., Uhlemann, M., & Ivey, A. (2004). In Gebo L. (Ed.), Essential interviewing: A programmed approach to effective communication (sixth ed.). Belmont, CA: Thomson Brooks/Cole. Hersoug, A. G., Hoglend, P., Havik, O., von der Lippe, A., & Monsen, J. (2009). Therapist characteristics influencing the quality of alliance in long-term psychotherapy. Clinical Psychology and Psychotherapy, 16(1), 100-110. doi:10.1002/cpp.605 Hiebert, B. (2001). Creating a working alliance: Generic interpersonal skills and concepts. University of Calgary. Retrieved from https://blackboard.ucalgary.ca/courses/1/CAAP605revised/content/_2057460_1/em bedded/Hiebert.pdf Horvath, A. (1993). The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology, 61(4), 561-573. Retrieved from Horvath, A. (2000). The therapeutic relationship: From transference to alliance. Psychotherapy in Practice, 56(2), 163-173. doi: 10.1002/1097-4679 Horvath, A. (2006). The alliance in context: Accomplishments, challenges, and future directions. Psychotherapy: Theory, Research, Practice, Training, 43(3), 258-263. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.ucalgary.ca/sp3.4.1b/ovidweb.cgi

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Rogers, C. (2007). The necessary and sufficient conditions of therapeutic personality change. Psychotherapy: Theory, Research, Practice, Training, 44(3), 240-248. doi:10.1037/0033-3204.44.3.240 Rogers, C., R. (1946). Significant aspects of client-centered therapy. The American Psychologist, 1, 415-422. Retrieved from OVID PsycArticles Ruglass, L., & Safran, J. (2005). Therapeutic alliance. Encyclopedia of Cognitive Behavior Therapy, 16, 405-408. doi:10.1007/0-306-48581-8_113 Safran, J., & Muran, C. (1996). The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology, 64(3), 447-458. doi:10.1037/0022006X.64.3.447 Safran, J., Muran, C., Samstag, L. W., & Stevens, C. (2001). Repairing alliance ruptures. Psychotherapy: Theory, Research, Practice, Training, 38(4), 406-412. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.ucalgary.ca/sp-3.4.1b/ovidweb.cg
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