DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

Type 2 refers to joint working and joint responsibility and is more typical of later phases
of treatment. These two types of alliances were found to be associated with the likelihood
of improvement in psychodynamic therapy.
Type 1 alliance may be influenced by levels of perceived warmth and care (e.g.
empathy), external features (e.g. attractiveness), contextual information (e.g. expertness),
and the client's past experiences in similar relationships (LaCrosse, 1980). These factors
are thought to influence the formation of a reciprocal relationship (Luborsky et al., 1985).
Bordin (1976, 1980, and 1989) proposed an influential conceptualisation of the working
alliance emphasising the client-therapist positive collaboration. He identified tasks, bonds
and goals as the three components of the alliance. Tasks refer to the behaviors and
cognitions or activities that the client and therapist engage in. In a positive relationship,
tasks must be perceived by both as appropriate and useful and both must accept the
responsibility to perform these tasks. The goals should be agreed and therefore represent
what the client wishes to gain from therapy. Bonds refer to the quality of the
interpersonal relationship and include issues such as mutual trust, acceptance and
confidence. To establish a good alliance it is important for the therapist to negotiate the
immediate and medium-term expectations and link these to the client's. The presence of a
strong alliance helps the patient to deal with the immediate discomforts associated with
the revealing of painful issues in therapy, as this may be part of the task leading to the
overall goal of treatment. The therapist needs to maintain an awareness of the client's
commitment to these activities and effectively intervene if it wanes.
Some common themes within the diverse conceptualisations
Bordins’ conceptualisation highlights the complex, dynamic, multidimensional and
interdependent nature of the relationship where the changing factors of the therapist,
patient and the approach specific factors all affect the therapeutic relationship at a given
time.
Any intervention will have an impact on the quality of the bond depending on the
idiosyncratic meaning the patient will give it and the experience of any intervention will
depend on the bond that has been established.
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