What is it about?

In group therapy, clients form relationships with the therapist, other group members, and the group-as-a-whole; these different kinds of relationships are referred to as alliance, cohesion, and climate, respectively. This study examines how these three different relationships relate to outcome in therapy among clients attending group therapy at a college counseling center. We predicted that having stronger relationships would be associated with better clients outcomes, and also that alliance, cohesion, and climate would have similar relationships with change in outcome over the course of therapy. Our results mostly supported our prediction that stronger alliance, cohesion, and climate would each relate to better therapy outcomes. However, when assessing whether their relationships with change in outcome were similar, we found that our prediction was not supported. More specifically, only alliance had a significant relationship with change in outcome. These results highlight the importance of the client-therapist relationship.

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Why is it important?

There has been a lot of research on what makes therapy work, with a question of what factors make it so that clients benefit from therapy. Prior research has suggested that relationships in therapy are one important factor, and this study builds upon that research by exploring how relationships are associated with outcome within group therapy. While other studies have engaged in similar endeavors, this study is unique because the data was (1) collected on a weekly basis and (2) drawn from a research-based questionnaire that can differentiate between alliance, cohesion, and climate. Thus, we believe that this study is able to contribute in important ways to the research literature as it overcomes the limitations of prior studies.


By helping people better understand the importance of relationships in group therapy (and especially the client-therapist relationship), we hope that this publication can advance group therapy research and inform clinical practice.

Rachel Arnold
Brigham Young University

Read the Original

This page is a summary of: The relationship of alliance, cohesion, and climate with outcome among college counseling populations., Journal of Counseling Psychology, March 2022, American Psychological Association (APA),
DOI: 10.1037/cou0000613.
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