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The Factor Structure of The Working Alliance Inventory in Cognitive-Behavioral Therapy

Received September 6, 2000; revised January 18, 2001; accepted January 24, 2001. From the Departments of Psychiatry and Psychology, University of Pennsylvania; and the Department of Psychology, Northwestern University, Evanston Campus. Address correspondence to Tomasz P. Andrusyna, Center for Psychotherapy Research, University of Pennsylvania School of Medicine, 3535 Market St., 6th Floor, Room 671, Philadelphia, PA 19104.

Studies of the therapeutic alliance in cognitive-behavioral therapy (CBT) have varied in their results, necessitating a deeper understanding of this construct. Through an exploratory factor analysis of the alliance in CBT, as measured by the Working Alliance Inventory (shortened, observer-rated version), the authors found a two-factor structure of alliance that challenges the commonly accepted one general factor of alliance. The results suggest that the relationship between therapist and client (Relationship) may be largely independent of the client's agreement with and confidence in the therapist and CBT (Agreement/ Confidence), necessitating independent measures of these two factors, not one measure of a general alliance factor.

Key Words: Alliance, Therapeutic • Cognitive-Behavioral Therapy • Rating Instruments

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