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Open Access Dissertation

Date of Award


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First Advisor

Mark A. Lumley


There is a considerable body of research related to both the therapeutic alliance and orienting clients to the psychotherapy process. This study is the first to examine the impact of a meta-communication orientation exercise regarding the therapeutic alliance on process variables and treatment outcomes. Participants (N=44) were randomly assigned to either a control or meta-communication condition where they engaged in an orientation exercise that combined elements of role induction and experiential pretraining regarding Bordin's (1979) model of the therapeutic alliance. Independent samples t-tests were used to determine if engaging in the orientation exercise would improve mood, ratings of the therapeutic alliance, level of experiencing, mental health symptoms, attendance, and therapists' ratings of overall improvement from therapy.

Findings show that the meta-communication exercise was influential in reducing the level of arousal that client's experienced, reduced levels of generalized anxiety, and led to more rapid symptom improvement. The orientation exercise also had the unintended effect of sensitizing clients to the level of disclosure taking place in the therapeutic relationship. Future studies will place more focus on addressing alliance issues in populations with substantial relational difficulties, such as those with diagnosed personality disorders. Subsequent research will also examine the impact of addressing alliance issues with this population in counseling centers that utilize brief treatment models.

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Psychology Commons