Graduate Program

Clinical Psychology

Degree Name

Master of Arts (MA)

Semester of Degree Completion

Summer 2021

Thesis Director

Mariana M. Juras

Thesis Committee Member

Anne M. Walk

Thesis Committee Member

Steven J. Scher


The purpose of this study was to explore the relationship between therapist practices, the therapeutic relationship and their impact on how transgender clients feel about their therapist. Previous research on therapist practices and the therapeutic relationship has looked into how these variables influence lesbian, gay, and bisexual clients’ feelings about their therapist, but as of yet, the dynamic has not been analyzed for transgender clients. Given the disproportionate prevalence for severe mental health issues in the transgender community, it is urgent that barriers to adequate and meaningful therapy outcomes be identified and addressed. Seventy eight participants were recruited from social media sites, such as Discord and Twitter, and Amazon Mechanical Turk (MTurk), to answer an online survey which included a demographic questionnaire, the Working Alliance Inventory – Short Form, the Real Relationship Inventory – Client Form, the Counselor Rating Form – Short, and the Therapist Practices (Adapted). Both the working alliance and the real relationship were found to significantly predict clients’ feelings about their therapists. The working alliance was found to have the strongest predictive power. The real relationship was also found to have significant predictive power. Similar to previous studies, affirming therapist practices did not add significance in predicting clients’ feelings about their therapist beyond the working alliance and real relationship.