EXPLORING PARALLEL PROCESS IN SUPERVISORY AND THERAPEUTIC PROCESSES: AN EXAMINATION OF RELATIONSHIP ALLIANCE AND THEIR PREDICTION OF OUTCOMES

Abstract

This thesis project explored parallels between clinical supervision and psychotherapy processes, and the possible impact of those parallels on client outcomes. This monograph includes a comprehensive literary review that illustrates the background against which the research was conducted. It also sets out the components on which the researcher focused, with an emphasis on whether relationship is a primary predictor of outcomes in psychotherapy. The research included two major areas of consideration: (a) to determine whether there is an association between the relational variables of alliance, autonomy, and affiliation at independent time points in the supervisory and therapeutic relationships, reflecting the possible presence of parallel process; and (b) to examine whether the relationship between therapeutic relational variables and client outcomes are moderated by supervisory relational variables. The association between the relational variables of alliance, autonomy, and affiliation at independent time points was inconsistent, and the first hypothesis was therefore only partially supported. The most significant finding of this study was that the relationship between the supervisory alliance and the therapeutic alliance was significantly associated with client outcomes. Specifically, results showed that supervisory alliance may play a moderating role in the relationship between client-rated therapeutic alliance and client outcomes, wherein poor therapeutic alliance was associated with poor client outcomes, particularly in the presence of a poor supervisory alliance. In contrast, when the supervisory alliance was high client outcomes were relatively better both when the therapeutic alliance was high and when it was low. Interestingly, this suggests that strong supervisory alliance may serve to buffer the negative effects of poor therapeutic alliance on worsening client outcomes, and that strong supervisory alliance may in fact enhance the relationship between high therapeutic alliance and better client outcomes. The relationship between clinical supervision and client outcomes has been the subject of various studies, yielding mixed results. While it is agreed that supervision is essential for the professional development of therapists, the limited previous research has not been able to solidify its direct influence on client outcomes. This study is one of the few that link supervision to positive client outcomes, and it connects with previous research in highlighting the need to leverage the potential benefits of parallel process. This requires that we gain greater understanding of parallel process and its impact on clinical work with clients. Ultimately, the results of the present study underscore the need for robust training programs that emphasize the development of strong supervisory and therapeutic alliances. In particular, this study highlights the importance of the supervisory alliance. This supports several previous studies that link strong supervisory alliance to better outcomes for clients, and suggests that leveraging parallel process to provide more fulsome training programs may ultimately lead to more effective services being delivered to clients and, ultimately, to better client outcomes.