Client-Rated Working Alliance Quality Relates to Perceptions of Therapists as Trustworthy Experts, Rather Than to Therapists' Positive Nonverbal Behavior

Abstract

Introduction: The present study sought a better understanding of the sources of client-perceived quality of the working alliance. Methods: At the end of psychotherapy sessions 3 and 5, 60 outpatient clients completed the Working Alliance Inventory-client form (WAI-c) and the Counselor Rating Form (CRF) measuring perceived therapists’ social power. At the same time, therapists estimated their clients’ WAI-c ratings (WAI-c-t). Also, frequency/duration of seven video-recorded positive nonverbal therapist behaviors in session 3 were coded. Results: WAI-c correlations with CRF were high (rs = .62 and .81) and WAI-c-moderate was (rs = .33 and .49). Nonverbal therapist codes, jointly (p = .64) and separately (ρs ≤ .14), were unrelated to WAI-c ratings, with the exception of Forward lean frequency (ρ = .29). Discussion: Client-perceived quality of the working alliance relates to therapists coming across as attractive, skilled, and trustworthy rather than to their actual positive nonverbal behavior.