A first look at the working alliance in psychotherapy with American Indians

We could find no published studies measuring the working alliance in outpatient psychotherapy with American Indians. Given that the working alliance has been shown to be one of the most reliable and robust predictors of outcome across psychotherapeutic modalities, we sought to understand the working alliance in this population. Eight psychotherapists in an urban outpatient clinic rated their working alliance with American Indian patients (n = 112) immediately after treatment delivery using the Working Alliance Inventory, 12-item short form (Tracey & Kokotovic, 1989). Working alliance data from 112 sessions were collected and compared with data from the Working Alliance Inventory, 12-item short form, normative sample (Busseri & Tyler, 2003). Therapist-rated working alliance in psychotherapy with American Indian patients was higher than a comparison sample. Alliance was unaffected by patient, therapist, or therapy-related variables in this sample. The working alliance is likely to be an important construct in psychotherapy with American Indian patients. Replication with a larger, representative group of therapists as well as the collection of patient and observer ratings are important next steps. (PsycInfo Database Record (c) 2021 APA, all rights reserved).