February 26, 2026
“Alliance and cohesion each predict group therapy outcome at b=.12, uniquely and independently — statistically indistinguishable from each other. If you track only alliance in your groups, you are measuring half the relational mechanism. The bonds among members matter as much as the bond with the therapist.”
“The first meta-analysis of clinical supervision (k=32) found large, significant effects on therapeutic alliance versus passive controls — supervision beats nothing. But versus active controls (peer consultation, structured feedback), effects shrink to small and non-significant. It is not that supervision doesn't work. It is that the specific format may matter less than the presence of any structured professional engagement.”
“A pre-registered single-case experimental study (N=34, routine care) found that structured discussion of psychometric feedback produced Hedges' g=1.33 in therapeutic alliance improvement — a large effect, causal by design, robust across case complexity. ROM is not just a monitoring tool. Used explicitly with patients, it is an alliance intervention.”
“The HIPAA telehealth waivers that permitted platforms like standard Zoom for therapy sessions expired with the COVID public health emergency. Therapists who haven't updated their platform, signed BAAs, and revised informed consent documentation since May 2023 are operating outside HIPAA compliance — and potentially outside their ethics code.”
“Ethics complaints to psychology licensing boards have increased every year since 2018 — and the category driving the growth has shifted from historical misconduct patterns toward technology-mediated violations: non-compliant telehealth platforms, social media boundary failures, and cross-state practice without licensure. The common thread is practitioners applying 2010 standards to a 2025 practice environment.”