Group-based processes as a framework for understanding the working alliance in therapy

Objective: The working alliance construct faces persistent issues with conceptualisation. We present a social identity analysis of working alliance. Here, we examine the links between alliance, the focal shared sense of “us” in social identification and identity leadership scholarship, and research on the role of “voice” (i.e., being provided with the opportunity to state one's own perspective to others) in enabling procedural justice. We hypothesised that working alliance would be predicted by group processes (i.e., social identification, identity leadership and procedural justice) and serve as an important mediator through which these processes enable desired therapeutic and organisational outcomes. Method: An online experiment sampled participants recently in therapy for a diagnosed mental disorder and recently employed. Participants were randomly assigned to recall either a therapy session or work meeting in which they had received or not received voice. Results: Social identification, identity leadership and procedural justice were found to account for approximately 70% of variance in working alliance. Working alliance, in turn, predicted positive affect, negative affect and satisfaction, in addition to mediating the relationship between group-based processes and these outcomes. Conclusion: These novel findings suggest that group-based processes are useful for conceptualising the working alliance in therapy, by both enhancing theory and providing practical clinical strategies for facilitating alliance.