The therapeutic alliance in offending behavior programs: A necessary and sufficient condition for change?

The nature and quality of the relationship that forms between clinicians and participants in an offending behavior program is considered by some to have a profound influence on treatment outcomes. This paper aims to offer a critical examination of the current evidence relevant to the effects of what has been termed the therapeutic alliance on violent offender treatment. It is concluded that there is currently an insufficient evidence base to support the view that the therapeutic alliance impacts either directly or indirectly on treatment outcomes and that other factors, such as offender motivation, treatment readiness, offender personality characteristics, and the way in which clinicians’ attend to participant problems, are also likely to be important. Nonetheless, it is concluded there are strong theoretical and practice grounds for clinicians to attend to the development and maintenance of strong alliances in offending behavior programs, and some recommendations for clinical practice in this area are offered.

► Critically examines evidence relevant to the effects of the ‘therapeutic alliance’.
► The alliance may act to moderate treatment outcomes.
► Research in this area is in its infancy.