Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Rodger K. Bufford

Second Advisor

Mary Peterson

Third Advisor

Robert Buckler


Research has found the therapeutic alliance to be the strongest predictor of successful outcomes from treatment (Orlinsky, Ronnestad, & Willutzki, 2003) . While many populations have been studied to determine successful outcomes through the strengthening of the therapeutic alliance, psychological literature lacks research targeting the specific group of sexual offenders. The present research addressed this gap in psychological literature. Research focused upon three treatment groups involving 19 sexual offenders. The study investigated four hypotheses: (a) symptoms will be reduced as a result of treatment, (b) helping alliance will improve over time in treatment, (c) the strength of the helping alliance will be related to the degree of symptom improvement, (d) feedback given to the therapist about empathy (component of helping alliance) will foster better treatment outcomes.

Preliminary outcome data was gathered using three different measures. The Helping Alliance Questionnaire II (HAQ II) is a widely used 19 item questionnaire that measures the strength of the client therapist alliance. The Empathy Scale Revised (ESR) is a 23-item test that asks patients to rate how caring, empathic, and genuine their therapists are. The Outcome Questionnaire 45.2 (OQ 45.2) is a 45-item test that measures distress symptoms. The pre-test included the HAQ-II, OQ-45.2, a demographic questionnaire, and an informed consent statement. The 2nd through the 11th week included only the ESR which was scored and interpreted by the lead researcher. The encoded results were then sent back to the lead therapist before the beginning of the next group session for the treatment group but not for control groups. The post-test included the OQ-45.2 and HAQ-II.

Results indicate that during the course of treatment symptoms were reduced. Similarly, the helping alliance was improved. Finally, the strength of the alliance was related to the degree of improvement in symptoms. However, the feedback of ESR information did not affect outcomes. These results suggest that an effective working alliance can be formed with sex offenders. Second, the helping alliance is at least somewhat related to outcomes. Third, even for the relatively short treatment period investigated, symptomatic improvement can occur among sex offenders.

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