Academic journal article College Student Journal

The University Student Perspective on Factors That Hinder the Counseling Alliance

Academic journal article College Student Journal

The University Student Perspective on Factors That Hinder the Counseling Alliance

Article excerpt

These two studies investigated the university student clients' perspective on factors that hinder the counseling alliance. In Study 1, twelve university students identified alliance-hindering factors while watching a videotape of their third or fourth counseling session. In total, 74 factors (in the form of participant statements) were elicited and these participants returned to sort them into categories of their own choosing. The university students who participated in Study 2 sorted the same 74 factors into conceptually homogenous categories and also categorized 74 reasons how or why the factors were thought to be hindering. In both studies, multivariate concept-mapping statistical techniques were used to identify the most typical conceptual structure used by participants in understanding conceptual interrelationships amongst the factors for all three sets of sorted statements. Alliance-hindering factors were classifiable into six categories (Study 1) and four categories (Study 2) and the reasons how or why they were hindering were classifiable into four categories. The results of these studies can be used to advance models of the counseling alliance for working with university students that better take into account clients' subjective perspectives, to help mental health professionals understand factors that could be impairing their therapeutic alliances, and to better instruct trainees in university counseling centers on alliance development.

Keywords: counseling alliance, therapeutic alliance, client's perspective

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The counseling (or therapeutic) alliance refers to the nature of the reciprocal working relationship between a mental health professional and client (Horvath & Bedi, 2002). Empirical evidence has shown that it is one of only four elements of the counseling relationship considered to be "demonstrably effective" for promoting positive counseling outcomes across virtually all counseling settings, including university counseling centers (Norcross, 2001, p. 345). The latest meta-analysis estimated that the alliance holds a median effect size of 0.28 on the outcome of counseling (Horvath, Del Re, Fluckiger & Symonds, 2011). Nevertheless, previous research has reported key discrepancies between practitioner and client ratings of the working alliance (Bedi, Davis, & Williams, 2005). In fact, practitioners' ratings of the alliance only correlate about .36 with clients' ratings (Tryon, Blackwell, & Hammel, 2007), while clients' ratings have usually been found to be the superior or predictor of positive counseling outcome (Horvath & Bedi, 2002).

Despite the established importance of the clients' perspective on the counseling alliance (Horvath & Bedi, 2002), evidence for its predictive validity (Duff & Bedi, 2010), and the fact that it is fundamentally different from the perspective of the practitioner (Fitzpatrick, Iwakabe, & Stalinkas, 2005), there is a distinct lack of research in this area. There is a noteworthy amount of research that intends to speak to the client's perspective, but that does not wholly assess the client's autonomous subjective perspective on the alliance; for example, by employing researchers who use their distinctive conceptual structures to sort client statements and declare the results as representing client understandings (e.g., Bedi, Davis, & Arvay, 2005; Bedi, Davis, & Williams, 2005). This unfortunate practice somewhat constrains understanding of the client's perspective to those conceptualizations already broadly consistent with investigator assumptions and pre-conceived notions (Bedi, 2006). Therefore, we know very little about what clients, themselves, believe is important for the therapeutic alliance, and practitioners thus have a very incomplete literature from which to draw upon to glean guidance for evidence-based practice.

Moreover, the few studies that have assessed the client's autonomous perspective on the alliance (e. …

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