Purpose

The scale is designed to evaluate the therapeutic alliance from the perspective of independent raters who observe psychotherapy sessions.

Brief Description

The WAIO consists of 3 subscales based on the theoretical analysis of the concept of the therapeutic alliance. The three dimensions are: (1) the client’s satisfaction with the therapeutic relationship, (2) agreement between client and therapist on the goals of therapy, and (3) agreement between client and therapist on the value and importance of the tasks/activities proposed during therapy. Responses are given on a five-point Likert scale (from “never” to “always”), and the final score is derived from the sum of values within each subscale.

Validity

There is sufficient evidence for construct validity, content validity, and empirical verification. The scale has been consistently used to evaluate the therapeutic relationship both qualitatively and quantitatively, with positive outcomes.

Reliability

Inter-rater reliability was satisfactory. Statistical analysis showed significant correlation among evaluations by independent observers across 18 therapy sessions, with correlation coefficients ranging from 0.43 to 0.81.

Data Analysis and Use

The scale was pilot-tested in a study of 18 sessions, each evaluated by three independent raters. Data are analyzed using parametric techniques, and the subscales may be used individually or as a composite score to assess the therapeutic alliance in both research and clinical settings.

Main Bibliographic Source

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