Therapists’ perspective on the therapeutic relationship: Examining a tripartite model

Abstract

The components of a tripartite model of the therapeutic relationship, namely the working alliance, the transference configuration (transference and countertransference), and real relationship, were examined in terms of how they relate to one another and to the outcome of a psychotherapy session, from the therapists’ perspective. Although previous studies have examined these components separately, no study to date has examined the components together in their relation to session outcome. Licensed psychotherapists (n = 249) were recruited from two Divisions of the American Psychological Association. Therapists completed measures for the last session they had with a client. Results revealed that from the therapist’s perspective the real relationship and working alliance related positively to session outcome, and countertransference behavior related negatively to session outcome. The components related to each other mostly as predicted by the tripartite model, and a principal-axis factor analysis revealed the presence of four distinct factors resembling the components theorized to comprise the tripartite model. The components together accounted for 27% of the variance in session outcome and only the real relationship and the working alliance predicted session outcome when all the components were looked at simultaneously in a regression model.