Measurement of Alliance

You have raised the important issue of how one goes about measuring alliance. I believe we have much to learn in this area. Indeed, who conducts the rating appears to make some difference. What exactly gets rated may be another issue. For example, I think quite subtle disruptions in the collaborative alliance are easily elicited by those who are new to CT unless training has carefully and thoroughly addressed the problem. Note, that in the NIMH study, most of the therapists were experienced therapists, but new to CT.

Another problem in teasing out the NIMH depression study data is the fact that when you divide the groups into most and least improved across treatments, the "n" for each treatment results in fairly low power.

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