Prior research in the psychotherapy field has yielded answers to the question: what makes therapy effective? Researchers have attempted to unearth which couple behaviors are destructive to couples' relational well-being, as well as the ways in which therapists hinder or help the floundering couple. This endeavor strives to review the literature that has examined themes that have emerged regarding effective couple therapy, and connect several concepts, including couple negativity, the active therapist, and the therapeutic alliance. A total of 112 couple and family cases were coded and evaluated by trained observers for specific client and therapist behaviors, as well as assessed the therapeutic alliance. As is the human condition, it is clear that a multitude of variables are at play when examining a construct as complicated as couple therapy. Stepwise regression analyses suggest that spousal and therapist behaviors integrate to form a synthesis that predicts an effective therapeutic alliance, therefore influencing couple therapy outcome.