Alliance

The home page of the ACORN toolkit shows a column of the most recent Alliance score on the client’s questionnaire. Low scores are color coded green and high scores are red.

Q: How does the alliance section work?

A: Therapeutic alliance has been found to predict psychotherapy outcomes more that treatment approach or experience of the therapist. But, there are a few things to know about making the most of your alliance feedback.

1. People will be polite and this is a problem. Those who report and excellent alliance early in treatment, and then mark it worse (even by a small amount) at the end of treatment (about 14%) have the worse results (average effect size of .6). 

2. The pattern associated with the best outcomes is that the client gives feedback early in therapy that the alliance was not perfect...there is room for improvement in some area. As treatment progresses, the alliance scores then get better. Overall, about 41% of cases fit this pattern, with a mean effect size of .85.  Those who report excellent alliance throughout therapy (about 45%) have a mean effect size of .78.

3. How do you get honest feedback? Communicate that you actually look at it, and continue to reference it throughout treatment. Need some tips?