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Working alliance as a mediator and moderator between expectations for counseling success and counseling outcome among Korean clients

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Abstract

The study examined client’s perceptions of working alliance as a mediator and moderator between client expectations of counseling success and counseling outcome. Participants were 284 adult clients in counseling in university or community counseling centers or private practices in South Korea. Level of functioning at the start of counseling was used to control for counseling outcome. Results of structural equation modeling analyses indicated that working alliance fully mediated the relationship between client expectations of counseling success and counseling outcome. In addition, moderation of counseling expectations by working alliance on counseling outcome was supported. Implications for research and practice are discussed.

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References

  • Abouguendia, M., Joyce, A. S., Piper, W. E., & Ogrodniczuk, J. S. (2004). Alliance as a mediator of expectancy effects in short-term group psychotherapy. Group Dynamics: Theory, Research, and Practice, 8, 3–12.

    Article  Google Scholar 

  • Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411–423.

    Article  Google Scholar 

  • Arnkoff, D. B., Glass, C. R., & Shapiro, S. J. (2002). Expectations and preferences. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 335–356). New York, NY: Oxford University Press.

    Google Scholar 

  • Asay, T. P., & Lambert, M. J. (1999). The empirical case for the common factors in therapy: Quantitative findings. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy? (pp. 23–55). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Bagozzi, R. P., & Edward, J. R. (1998). A general approach for representing constructs in organizational research. Organizational Research Methods, 1, 45–87.

    Article  Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Frbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–591.

    Article  Google Scholar 

  • Bergin, A. E., & Garfield, S. L. (Eds.). (1994). Handbook of psychotherapy and behavior change (4th ed.). Oxford: Wiley.

    Google Scholar 

  • Bohart, A. C., & Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart and soul of change: Delivering what works in therapy (2nd ed., pp. 83–111). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, and Practice, 16, 252–260.

    Article  Google Scholar 

  • Brislin, R. W., Lonner, W. J., & Thorndike, R. M. (1973). Cross-cultural research method. New York: Wiley.

    Google Scholar 

  • Busseri, M. A., & Tyler, J. D. (2003). Interchangeability of the working alliance inventory and working alliance inventory, short form. Psychological Assessment, 15, 193–197.

    Article  Google Scholar 

  • Castonguay, L. G., Constantino, M. J., & Holtforth, M. (2006). The working alliance: Where are we and where should we go? Psychotherapy, 43, 271–279.

    Article  Google Scholar 

  • Connolly Gibbons, M. B., Crits-Christoph, P., de la Cruz, C., Barber, J. P., Siqueland, L., & Gladis, M. (2003). Pretreatment expectations, interpersonal functioning, and symptoms in the prediction of the therapeutic alliance across supportive-expressive psychotherapy and cognitive therapy. Psychotherapy Research, 13, 59–76.

    Article  Google Scholar 

  • Constantino, M. J. (2012). Believing is seeing: An evolving research program on patients’ psychotherapy expectations. Psychotherapy Research, 22, 127–138.

    Article  Google Scholar 

  • Constantino, M. J., Ametrano, R., & Greenberg, R. P. (2012). Clinician intervention and participant characteristics that foster adaptive patient expectations for psychotherapy and psychotherapeutic change. Psychotherapy, 49, 557–569.

    Article  Google Scholar 

  • Constantino, M. J., Arnow, B. A., Blasey, C., & Agras, W. S. (2005). The association between patient characteristics and the therapeutic alliance in cognitive-behavioral and interpersonal therapy for bulimia nervosa. Journal of Consulting and Clinical Psychology, 73, 203–211.

    Article  Google Scholar 

  • Constantino, M. J., Glass, C. R., Arnkoff, D. B., Ametrano, R. M., & Smith, J. Z. (2011). Expectations. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed., pp. 354–376). New York, NY: Oxford University Press.

    Chapter  Google Scholar 

  • Constantino, M. J., Manber, R., Ong, J., Kuo, T. F., Huang, J. S., & Arnow, B. A. (2007). Patient expectations and therapeutic alliance as predictors of outcome in group cognitive-behavioral therapy for insomnia. Behavioral Sleep Medicine, 5, 210–228.

    Article  Google Scholar 

  • Constantino, M. J., Marnell, M. E., Haile, A. J., Kanther-Sista, S. N., Wolman, K., Zappert, L., et al. (2008). Integrative cognitive therapy for depression: A randomized pilot comparison. Psychotherapy: Theory, Research, Practice, Training, 45, 122–134.

    Article  Google Scholar 

  • Derogatis, L. R. (1977). The SCL-90 Manual I: Scoring, administration and procedures for the SCL-90. Baltimore: Johns Hopkins University School of Medicine, Clinical Psychometrics.

  • DeRubeis, R. J., Brotman, M. A., & Gibbons, C. J. (2005). A conceptual and methodological analysis of the nonspecific argument. Clinical Psychology: Science and Practice, 12, 174–183.

    Google Scholar 

  • Ellsworth, J. R., Lambert, M. J., & Johnson, J. (2006). A comparison of the outcome questionnaire-45 and outcome questionnaire-30 in classification and prediction of treatment outcome. Clinical Psychology and Psychotherapy, 13, 380–391.

    Article  Google Scholar 

  • Fisher, A. R., Jome, L. M., & Atkinson, D. R. (1998). Reconceptualizing multicultural counseling: Universal healing conditions in a culturally specific context. The Counseling Psychologist, 25, 525–588.

    Article  Google Scholar 

  • Frank, J. D., & Frank, J. B. (1991). Persuasion and healing: A comparative study of psychotherapy (3rd ed.). Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  • Gelso, C. J., & Palma, B. (2011). Directions for research on self-disclosure and immediacy: moderation, mediation, and the inverted U. Pyschotherapy, 48, 342–348.

    Article  Google Scholar 

  • Greenberg, R. P., Constantino, M. J., & Bruce, N. (2006). Are patient expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review, 26, 657–678.

    Article  Google Scholar 

  • Hambleton, R. K. (1994). Guidelines for adapting educational and psychological tests: A progress report. European Journal of Psychological Assessment, 10, 229–244.

  • Horowitz, L. M., Rosenberg, S. E., Baer, B. A., Ureno, G., & Billasetror, V. S. (1988). Inventory of interpersonal problems: Psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology, 56, 885–892.

    Article  Google Scholar 

  • Horvath, A. O. (2005). The therapeutic relationship: Research and theory. Psychotherapy Research, 15, 3–7.

    Article  Google Scholar 

  • Horvath, A. O., & Bedi, R. P. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 37–70). New York, NY: Oxford University Press.

    Google Scholar 

  • Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9–16.

    Article  Google Scholar 

  • Horvath, A. O., & Greenberg, L. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36, 223–232.

    Article  Google Scholar 

  • Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology, 61, 561–573.

    Article  Google Scholar 

  • Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Consulting and Clinical Psychology, 38, 139–149.

    Google Scholar 

  • Hu, L. T., & Bentler, P. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • Kim, S. Y., & Jang, H. H. (2011). The effects of adolescent client’s expectations about counseling on working alliance and counseling outcome. The Korea Journal of Youth Counseling, 19, 155–170.

    Google Scholar 

  • Kim, B. S. K., Ng, G. F., & Ahn, A. J. (2005). Effects of client expectation for counseling success, client-counselor worldview match and client adherence to Asian and European American cultural values on counseling process with Asian Americans. Journal of Counseling Psychology, 52, 67–76.

    Article  Google Scholar 

  • Kim, B. S. K., Ng, G. F., & Ahn, A. J. (2009). Client adherence to Asian cultural values, common factors in counseling, and session outcome with Asian American clients at a university counselingcenter. Journal of Counseling & Development, 87, 131–142.

    Article  Google Scholar 

  • Kim, E. H., & Park, S. M. (2011). The trends and issues of research on the working alliance in Korea. The Korean Journal of Counseling and Psychotherapy, 23, 1–25.

    Google Scholar 

  • Kim, M. S., & Yoon, M. S. (2010). The structural relationship among stigma, expectation, involuntary, and psychological reactance in counseling with Korean adolescent clients. The Korean Journal of Counseling and Psychotherapy, 22, 301–328.

    Google Scholar 

  • Lambert, M. J., Hatfield, D. R., Vermeersch, D. A., Burlingame, G. M., Reisinger, C. W., & Brown, G. S. (2001). Administration and scoring manual for the Life Status Questionnaire. Stevenson, MD: American Professional Credentialing Services LLC.

    Google Scholar 

  • Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.

    Article  Google Scholar 

  • Meyer, B., Pilkonis, P. A., Krupnick, J. L., Egan, M. K., Simmens, S. J., & Sotsky, S. M. (2002). Treatment expectancies, patient alliance, and outcome: Further analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 70, 1051–1055.

    Article  Google Scholar 

  • Patterson, C. L., Uhlin, B., & Anderson, T. (2008). Clients’ pretreatment counseling expectations as predictors of the working alliance. Journal of Counseling Psychology, 55, 528–534.

    Article  Google Scholar 

  • Ping, R. A. (1996). Latent variable interaction and quadratic effect estimation: A two-step technique using structural equation analysis. Psychological Bulletin, 119, 166–175.

    Article  Google Scholar 

  • Safran, J. D., Muran, J. C., & Eubanks-Carter, C. (2011). Repairing alliance rupture. Psychotherapy, 48, 80–87.

    Article  Google Scholar 

  • Schlomer, G. L., Bauman, S., & Card, N. A. (2010). Best practices for missing data management in counseling psychology. Journal of Counseling Psychology, 57, 1–10.

    Article  Google Scholar 

  • Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445.

    Article  Google Scholar 

  • Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the working alliance inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1, 207–210.

    Article  Google Scholar 

  • Vermeersch, D. A., Lambert, M. J., & Burlingame, G. M. (2000). Outcome questionnaire 45: Item sensitivity to change. Journal of Personality Assessment, 74, 242–261.

    Article  Google Scholar 

  • Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates Publishers.

    Google Scholar 

  • Wampold, B. E. (2007). Psychotherapy: The humanistic (and effective) treatment. American Psychologist, 62, 857–873.

    Article  Google Scholar 

  • Wei, M., Mallinckrodt, B., Russell, D. W., & Abraham, W. T. (2004). Maladaptive perfectionism as a mediator and moderator between adult attachment and depressive mood. Journal of Counseling Psychology, 31, 201–212.

    Article  Google Scholar 

  • West, S. G., Finch, J. F., & Curran, P. J. (1995). Structural equation models with non-normal variables: Problems and remedies. In R. Hoyle (Ed.), Structural equation modeling: Concepts, issues and application (pp. 56–75). Newbury Park, CA: Sage.

    Google Scholar 

  • Westra, H. A., Constantino, M. J., & Aviram, A. (2011). The impact of alliance rupture on client outcome expectations in cognitive behavioral therapy. Psychotherapy Research, 21, 472–481.

    Article  Google Scholar 

  • Yoo, S. K., & Yoo, J. I. (2000). Individualism-collectivism and tolerance of stigma associated with seeking. The Korean Counseling and Psychotherapy, 12, 19–32.

    Google Scholar 

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Authors and Affiliations

  1. Ewha Womans University, Seoul, Korea

    Sung-Kyung Yoo & Nanhee Sohn

  2. Korea University, Seoul, Korea

    Sehee Hong

  3. University of Maryland, College Park, MD, USA

    Karen M. O’Brien

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  1. Sung-Kyung Yoo
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  2. Sehee Hong
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  3. Nanhee Sohn
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  4. Karen M. O’Brien
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Correspondence to Sung-Kyung Yoo.

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Yoo, SK., Hong, S., Sohn, N. et al. Working alliance as a mediator and moderator between expectations for counseling success and counseling outcome among Korean clients. Asia Pacific Educ. Rev. 15, 271–281 (2014). https://doi.org/10.1007/s12564-014-9320-2

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  • DOI: https://doi.org/10.1007/s12564-014-9320-2

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