Therapeutic alliance is considered important for successful counseling. Alliances between a therapist and couples or family members become complicated because of multiple interactions. This literature review examines sample size, participant assignment, and generalizability in 19 marital and family therapy studies on therapeutic alliance published 1989 through 2003. Eleven studies had inadequate sample sizes. Most of the assignment strategies include convenience and purposive samples conducted with YAVIS (young, adult, verbal, intelligent, stable) populations. Studies lacked diversity in participant demographics and treatment sources. None of the studies factor how therapist experience and therapeutic setting affect therapeutic alliances. These studies do support therapeutic alliance as an integral part of marital and family counseling, theory, and assessment.
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