Strong working alliance is a critical part of rehabilitation counseling, yet few studies have explored client predictors of alliance. Based on interpersonal theory, this study investigated the relationship between client interpersonal problems and working alliance during vocational rehabilitation. A sample of 325 individuals with disabilities from two state vocational rehabilitation agencies participated in the study. Bivariate analyses showed that greater interpersonal problems were associated with weaker working alliance. In a hierarchical regression analysis, submissive/hostile interpersonal problems significantly predicted lower working alliance scores. These findings suggest that interpersonal problems, such as social withdrawal and emotional disengagement, impede the development of working alliance. The results support the integration of interpersonal assessments and alliance-focused strategies into rehabilitation counseling to enhance engagement and improve client outcomes.
AckermanS. J.HilsenrothM. J.BaityM. R.BlagysM. D. (2000). Interaction of therapeutic process and alliance during psychological assessment. Journal of Personality Assessment, 75(1), 82–109. https://doi.org/10.1207/S15327752JPA7501_7
2.
AkinolaO.TorresA. (2024). Exploring the role of therapeutic alliance and client functioning in vocational rehabilitation engagement among clients with mental disabilities. Journal of Psychosocial Rehabilitation and Mental Health. Advance online publication. https://doi.org/10.1007/s40737-024-00395-2
3.
AldenL. E.WigginsJ. S.PincusA. L. (1990). Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment, 55(3–4), 521–536. https://doi.org/10.1080/00223891.1990.9674095
4.
BerettaV.FavaL.BalestrieriM.PeriniG. (2005). Alliance ruptures and resolution in a 12-session supportive-expressive therapy. Psychotherapy: Theory, Research, Practice, Training, 42(3), 220–232. https://doi.org/10.1037/0033-3204.42.3.220
5.
BordinE. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. https://doi.org/10.1037/h0085885
6.
BucherM. A.SuzukiT.SamuelD. B. (2019). A meta-analytic review of personality traits and their associations with mental health treatment outcomes. Clinical Psychology Review, 70, 51–63. https://doi.org/10.1016/j.cpr.2019.04.002
7.
CarsonR. (2017). Interpersonal behavior: History and practice of personality theory. Routledge.
8.
CastonguayL. G.ConstantinoM. J.HoltforthM. G. (2006). The working alliance: Where are we and where should we go?Psychotherapy: Theory, Research, Practice, Training, 43(3), 271. https://doi.org/10.1037/0033-3204.43.3.271
9.
ChanF. (2015). Counseling theories and techniques for rehabilitation and mental health professionals. Springer Publishing Company.
10.
ChanF.CardosoE. D.ChronisterJ. A. (2004). Understanding the working alliance between consumers and counselors in rehabilitation: Measurement and implications for practice. Rehabilitation Counseling Bulletin, 47(3), 166–174. https://doi.org/10.1177/003435520404700306
11.
ConstantinoM. J.Smith-HansenL. (2008). Patients’ interpersonal subtypes and outcome expectations for psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 45(3), 366–370. https://doi.org/10.1037/a0013310
12.
DonnellC. M.LustigD. C.StrauserD. R. (2004). The working alliance: Rehabilitation outcomes for persons with severe mental illness. Journal of Rehabilitation, 70, 12–18.
13.
FlückigerC.Del ReA. C.WampoldB. E.HorvathA. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340. https://doi.org/10.1037/pst0000172
14.
GastonL. (1990). The concept of the alliance and its role in psychotherapy: Theoretical and empirical considerations. Psychotherapy, 27, 143–153. https://doi.org/10.1037/0033-3204.27.2.143
15.
GurtmanM. B. (1996). Interpersonal problems and the psychotherapy context: The construct of the therapeutic space. Journal of Personality Assessment, 66(2), 303–322. https://doi.org/10.1207/s15327752jpa6602_12
16.
HatcherR. L.BarendsA. W. (2006). Patients’ and therapists’ shared and unique views of the therapeutic alliance: An investigation using confirmatory factor analysis in a nested design. Journal of Consulting and Clinical Psychology, 74, 636–643. https://doi.org/10.1037/0022-006X.74.4.636
17.
HorowitzL. M.AldenL. E.WigginsJ. S.PincusA. L. (2000). Inventory of Interpersonal Problems (IIP) Manual. The Psychological Corporation.
18.
HorvathA. O.SymondsB. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38(2), 139. https://doi.org/10.1037/0022-0167.38.2.139
19.
KieslerD. J. (1983). The 1982 interpersonal circle: A taxonomy for complementarity in human transactions. Psychological Review, 90(3), 185–214. https://doi.org/10.1037/0033-295X.90.3.185
20.
KieslerD. J. (1996). Contemporary interpersonal theory and research: Personality, psychopathology, and psychotherapy. Wiley.
21.
LambertM. J.BarleyD. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38, 357–361. https://doi.org/10.1037/0033-3204.38.4.357
22.
LustigD. C.StrauserD. R.DonnellC. M. (2002). The relationship between working alliance and rehabilitation outcomes. Rehabilitation Counseling Bulletin, 46, 25–33. https://doi.org/10.1177/003435520204600104
23.
MartinD. J.GarskeJ. P.DavisM. 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. https://doi.org/10.1037/0022-006X.68.3.438
24.
MunderT.WilmersF.LeonhartR.LinsterH. W.BarthJ. (2010). Working Alliance Inventory-Short Revised (WAI-SR): Psychometric properties in outpatient samples. Psychotherapy Research, 20(5), 593–605. https://doi.org/10.1080/10503307.2010.49342
25.
MuranJ. C.BarberJ. P.MohrJ. J. (2010). The therapeutic alliance: An evidence-based guide to practice. Guilford Press.
26.
PincusA. L.AnsellE. B. (2003). Interpersonal theory of personality. In MillonT.LernerM.WeinerI. (Eds.), Handbook of psychology: Personality and social psychology (pp. 209–229). John Wiley & Sons.
27.
PuschnerB.KraftS.BauerS. (2004). Interpersonal problems and outcome in outpatient psychotherapy: Findings from a long-term longitudinal study in Germany. Journal of Personality Assessment, 83(3), 223–234. https://doi.org/10.1207/S15327752JPA8303_06
28.
ReyesA.GrenawaltT. A.PhillipsB. N.ReyesC. P. (2021). The tripartite efficacy beliefs model in vocational rehabilitation: Implications for working alliance and client engagement. Journal of Vocational Rehabilitation, 55(1), 81–89. https://doi.org/10.3233/JVR-211148
29.
ReyesA.PhillipsB. N.Kriofske MainellaA. M. (2024). Applications for interpersonal theory in rehabilitation counseling. Rehabilitation Education. https://doi.org/10.1891/RE-24-07
30.
SaundersS. M.HowardK. L.OrlinskyD. E. (1989). The therapeutic bond scales: Psychometric characteristics and relationship to treatment effectiveness. Psychological Assessment, 1, 323–330. https://doi.org/10.1037/1040-3590.1.4.323
31.
ShawL. R.McMahonB. T.ChanF.HannoldE. (2004). Enhancement of the working alliance: A training program to align counselor and consumer expectations. Journal of Vocational Rehabilitation, 20, 107–126.
32.
SodanoS. M.TraceyT. J. G. (2011). Interpersonal rigidity and symptoms: A circular model of psychopathology. Journal of Counseling Psychology, 58(3), 347–356. https://doi.org/10.1037/a0024247
33.
StilesW. B.GlickM. J.OsatukeK.HardyG. E.ShapiroD. A.Agnew-DaviesR.BarkhamM. (2004). Patterns of alliance development and the rupture–repair hypothesis: Are productive relationships U-shaped or V-shaped?Journal of Counseling Psychology, 51(1), 81–92. https://doi.org/10.1037/0022-0167.51.1.81
34.
StrauserD. R.LustigD. C.ChanF.O’SullivanD. (2010). The relationship between working alliance and employment outcomes in rehabilitation counseling. Rehabilitation Counseling Bulletin, 53, 80–85. https://doi.org/10.1177/00343552020460010201
35.
StrauserD. R.LustigD. C.DonnellC. M. (2004). The relationship between working alliance and therapeutic outcomes for individuals with mild mental retardation. Rehabilitation Counseling Bulletin, 47(4), 215–223. https://doi.org/10.1177/00343552040470040301
36.
SullivanH. S. (1953). The interpersonal theory of psychiatry. Norton.
37.
TraceyT. J. G.RoundsJ.GurtmanM. B. (1996). Examination of the circular structure of the interpersonal circumplex. Journal of Personality and Social Psychology, 70(4), 936–947. https://doi.org/10.1037/0022-3514.70.4.936
38.
WampoldB. E. (2001). The great psychotherapy debate: Models methods, and findings. Erlbaum.
39.
WampoldB. E.ImelZ. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work. Routledge.
