The Effect of Working Alliance on Client Drop-out for Persons with Disabilities in a State-Federal Vocational Rehabilitation Agency
Fabian ,Ph.D., Ellen
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The existence of a working alliance between a counselor and a client has been viewed as a critical component of the therapeutic process in the psychological literature (Bachelor, 1995). The construct of working alliance has been the focus of interest in research literature as a measure of positive therapy outcomes. According to Horvath (2001 ) two decades of empirical research have consistently linked the quality of the alliance between therapist and client with therapy outcome. The 1998 Amendments to the Rehabilitation Act mandate that persons with disabilities must be "active and full partners" in the rehabilitation process. In the federal-state rehabilitation setting there is limited time to form an alliance( Safran&Muran, 1998), so that the initial interview becomes critical in engaging the client in this process. Therefore, this study measured the working alliance after the initial in-take session. Working alliance was measured by the Working Alliance Inventory (WAI) developed by Horvath & Greenberg (1989). The dependent variable was the Individualized Plan for Employment (IPE) which represents the agreed upon goals and tasks between the DORS counselor and client. The major hypothesis was that a strong working alliance between counselor and client would predict an IPE, and a poor alliance would not. The study participants were 111 persons with disabilities who applied and were found eligible for services in FY 2006 through the Maryland Division of Rehabilitation Services (DORS). The investigation was conducted at 16 DORS offices throughout the state . The major finding was the lack of any significant relationship between working alliance and IPE . The second major finding was the clients gave generally high WAI scores to DORS counselors and 59 % (66) had an IPE. Despite this positive finding , those with high WAI scores were no more likely to have an IPE .Additionally, there was an effect of disability category upon the WA. In summary, the findings suggest that factors external to the WA may be more significant barriers to employment outcomes for DORS clients. The implications for people with disabilities, counselors, and counselor educators are discussed within the context of these findings.