It is almost a truism that the therapeutic alliance is important to patient outcomes in psychological treatments. therapeu The tic alliance is one of the most researched concepts in psycho- therapy (Horvath, Del Re, Fluckiger & Symonds, 2011). The alliance refers to an agreement between therapist and client on the tasks and goals of therapy, and the collaborative bond (Bordin, 1979). A large meta-analysis of over 200 studies found that the alliance-outcome correlation was .275, indicating a robust moderate effect (Horvath et al., 2011). In a study to assess the dependability of alliance measurement, Crits Christoph and colleagues (2011) argued that the alliance- outcome correlation is probably attenuated by measurement error. That is, when multiple assessments of alliance were taken within individual patients or therapists (a relatively uncommon occurrence in therapeutic alliance research), the alliance- outcome association likely was larger.