Predicting Client-Rated Session Depth and Alliance in Trainees’ First Clinical Encounter: The Contribution of Therapist Characteristics and Technique Usage

This study investigates whether trainee personal characteristics and technique usage can predict client-rated depth and alliance. A multitrait–multimethod assessment (age, Graduate Record Examination [GRE] score, interpersonal problems, perspective taking, and emotional investment in relationships) of clinical graduate trainees (N = 65) was collected prior to training and matched to process measures obtained from the third session of their first training case. Process measures included the following: observer ratings of exploration, insight, action, and supportive techniques, as well as client ratings of alliance and depth. Regression results indicated that therapist characteristics and technique usage significantly predicted client-rated depth with GRE (negative), action (negative), and support (positive) being significant individual predictors. While the overall two-step regression model was not significant for alliance, there was a significant positive correlation with a moderate effect for observer-rated usage of support and client-rated alliance. Exploratory regression results indicated technique usage variables independently predicted client alliance ratings with support (positive) having the largest unique contribution. Implications for the selection and training of therapists are discussed.