Date of Defense

4-24-2026

Date of Graduation

5-2026

Department

Speech, Language and Hearing Science

First Advisor

Matthew Dumican

Second Advisor

Katherine Rigley

Third Advisor

Allison Mezo

Abstract

Background: The therapeutic alliance (TA), defined as the collaborative relationship between clinician and client, is widely recognized as a key factor influencing rehabilitation outcomes. However, within aphasia rehabilitation, its role remains underexplored and inconsistently measured

Methods: This narrative review examined peer-reviewed studies published between 1990 and 2025 that focused on adult aphasia rehabilitation and addressed the client-clinician relationship. Studies were identified through database searches, including PubMed, CINAHL, ComDisDome, EBSCO, and Google Scholar, and analyzed using thematic analysis.

Results: Most of the studies employed qualitative methodologies, particularly thematic analysis and semi-structured interviews, to explore patient and clinician perspectives. The therapeutic alliance was consistently identified through themes such as trust, empathy, collaboration, and patient-centered goal setting. Despite this, only two studies utilized A standardized measure of the therapeutic alliance, while most addressed it conceptually indirectly, while in therapy processes, in contrast, rehabilitation disciplines more frequently incorporate structured tools to assess the therapeutic alliance.

Conclusion: The therapeutic alliance is recognized as a critical component of aphasia rehabilitation but is rarely operationalized or measured. Further research should prioritize the development and integration of standardized tools, such as a therapeutic alliance reflection checklist (TARC), to better evaluate and support the therapeutic alliance and clinical practice.

Access Setting

Honors Thesis-Open Access

Additional Files
Thesis Presentation.pdf (1147 kB)
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