Description

The Client Assessment of Therapeutic Alliance in Psychotherapy Scale (KATHS) is a psychometric instrument designed to evaluate the therapeutic alliance from the client’s perspective. The scale focuses on the subjective experience of the therapeutic relationship and examines how clients perceive their collaboration, connection, and satisfaction with their therapist during psychotherapy.

KATHS assesses three central dimensions of the therapeutic alliance. The first dimension concerns the client’s satisfaction with the therapeutic relationship, reflecting the extent to which clients feel comfortable, supported, and positively engaged within therapy. The second dimension evaluates agreement between therapist and client regarding therapeutic goals, emphasizing collaboration and shared understanding of the objectives of treatment. The third dimension focuses on positive attachment between therapist and client, representing the emotional bond and trust developed within the therapeutic relationship.

The questionnaire is completed directly by the client and provides information regarding the individual’s personal experience of the therapeutic process. This client-centered approach allows the assessment of alliance characteristics that may influence psychotherapy engagement and outcomes.

Data Analysis and Use

Data obtained through KATHS can be analyzed to quantitatively assess the quality of the therapeutic alliance and examine relationships between alliance characteristics and psychotherapy outcomes.

The scale has been applied to a sample of 18 psychotherapy sessions and evaluated by three independent raters. The findings indicated satisfactory inter-rater reliability, while evidence was also reported supporting construct validity, discriminant validity, and criterion-related validity.

The instrument may be used in psychotherapy research to examine therapist–client interactions, evaluate the development of therapeutic relationships, and investigate factors associated with effective psychotherapy. In clinical practice, KATHS may provide useful feedback regarding the client’s perception of the therapeutic relationship and support supervision and therapist training processes.

The scale is particularly valuable in research examining the role of therapeutic alliance as a factor contributing to treatment effectiveness, client engagement, and satisfaction with psychotherapy.

Objective

The primary objective of the KATHS is to evaluate the quality of the therapeutic alliance between therapist and client.

The therapeutic alliance represents the collaborative relationship established during psychotherapy and includes agreement regarding treatment goals, cooperation during therapeutic tasks, and the emotional bond between therapist and client.

By assessing the client’s perspective, KATHS aims to provide information about how effectively the therapeutic relationship is being established and maintained. Measuring therapeutic alliance is considered important for understanding psychotherapy processes and improving the effectiveness of psychological interventions.

Structure and Content

KATHS consists of three subscales representing the main components of the therapeutic alliance.

The first subscale assesses client satisfaction with the therapeutic relationship, examining the degree to which the client experiences the therapeutic relationship as supportive and beneficial.

The second subscale evaluates agreement regarding therapeutic goals, reflecting the extent to which the client perceives that therapist and client share a common understanding of the aims and direction of therapy.

The third subscale examines positive attachment between therapist and client, focusing on aspects such as trust, emotional connection, and the quality of the interpersonal bond.

Together, these dimensions provide an integrated evaluation of the therapeutic alliance from the client’s viewpoint.

Scoring

KATHS uses a Likert-type response format, in which clients indicate their level of agreement with statements describing aspects of the therapeutic relationship.

The exact response range is not specified in the available description. However, the scale provides separate scores for each subscale, allowing evaluation of satisfaction with the relationship, goal agreement, and positive attachment. An overall therapeutic alliance score may be calculated by combining or averaging the relevant item responses.

Higher scores indicate a stronger therapeutic alliance, reflecting greater satisfaction, stronger collaboration regarding treatment goals, and a more positive emotional connection between client and therapist.

The precise scoring procedure, response anchors, item weighting, and interpretation criteria should be determined according to the official administration manual of the scale.

Statistical Analysis

Statistical evaluation of KATHS may include descriptive statistics, reliability analysis, and validity assessment.

Descriptive procedures, including calculation of means and standard deviations, can be used to describe perceived therapeutic alliance levels within a sample. Reliability analysis may examine the internal consistency of the subscales, while inter-rater reliability can evaluate agreement between independent evaluators when applicable.

Validity analyses may include examination of construct validity, discriminant validity, and criterion-related validity, as reported in the application of the scale.

The instrument can also be used in psychotherapy research to investigate associations between therapeutic alliance scores and treatment outcomes, client satisfaction, adherence to therapy, or therapist-related variables.

Validity

KATHS demonstrates evidence of psychometric validity through findings supporting construct validity, discriminant validity, and criterion-related validity.

The scale has been theoretically developed based on established concepts of therapeutic alliance and empirically evaluated within psychotherapy contexts. Its application within the Greek population has provided support for its suitability as a measure of the therapeutic relationship.

Further validation studies may examine its applicability across different therapeutic approaches, clinical populations, and cultural contexts.

Reliability

The available information indicates that KATHS demonstrates satisfactory reliability characteristics, particularly regarding inter-rater reliability.

The scale was evaluated by three independent raters in psychotherapy sessions, and agreement between evaluators was found to be satisfactory.

The available description does not provide specific numerical reliability coefficients, such as Cronbach’s alpha values or test–retest reliability coefficients. Therefore, specific reliability estimates should be obtained from the original validation studies of the instrument.

References

Chalkiadaki, A., Kalaitzaki, A. E., & Nestoros, J. (2003). The therapeutic relationship in the Integrative Psychotherapy Model: A case study. 9th Panhellenic Conference of Psychological Research, Rhodes.