The Role and Relevance of the Working Alliance in Forensic Treatment: A Meta-Analysis

The working alliance has been extensively studied and consistently linked to improved treatment outcomes; however, existing reviews have almost exclusively focused on non-forensic samples, which differ significantly in client characteristics, treatment goals, and settings. Therefore, prior reviews may not generalize to forensic contexts. Seeking to fill this gap in the literature, a meta-analysis of the working alliance in forensic treatment contexts was conducted and its relationship to risk-relevant treatment outcomes was examined featuring k = 21 unique studies. All three treatment outcomes examined-treatment dropout (d = 0.390), institutional misconduct (d = 0.374), and community recidivism (d = 0.196)-were significantly and negatively associated with the working alliance. These findings demonstrate the working alliance as a meaningful predictor of treatment outcomes in forensic contexts. Implications for research and practice are discussed to promote more favorable treatment outcomes for forensic clients.