Pre-treatment client interpersonal problems relation to the initial working alliance using multilevel modeling

This study examined the relationship of client pretreatment interpersonal problems (measured by the Inventory of Interpersonal Problems) to the therapeutic alliance (as measured early in treatment by a self report version of the Working Alliance Inventory‐ Short) using multilevel modeling to account for client and counselor variables. Specifically, the correlations of dominance, hostility and cold/distance interpersonal problems with the initial working alliance were investigated. Participants consisted of 144 clients and 44 graduate student counselors at the Counselor Training Center at Arizona State University. The intraclass value of .23 indicated there is a sizable effect, with counselor differences accounting for 23% of the variance in client alliance ratings, supporting the use of multilevel modeling. There was a dominance counselor gender interaction with working alliance scores. Clients who had problems with dominance reported higher working alliance scores with male counselors while clients who had problems with submissiveness reported higher working alliance scores with female counselors. Hostile dominance interpersonal problems were associated with lower initial working alliance scores regardless of counselor gender. Implications for clinical practice are discussed.