Change in working alliance, social support, and psychological symptoms in brief therapy

Many interpersonal therapists use the working alliance as a vehicle for client change and as a corrective experience for clients to learn new relationship skills. Clients in brief therapy (N = 34) completed measures of social support and psychological symptoms at pretest and termination and a measure of working alliance after the third session and at termination. Path analysis suggested that improvement in the working alliance was significantly related to improvement in social support and that improvement in social support was significantly related to symptom reduction. The working alliance appears to have an important indirect connection to symptom reduction, through the mediating influence of increased support. After the effects of improved alliance were controlled, increased support was still related to decreased symptoms; however, after the effects of social support were controlled, the relation between change in alliance and symptoms was not significant.