The alliance in Child and Adolescent
Psychotherapy
Diagnostiek deel B (page 17-24).
It’s a meta-analysis instead of the study itself (reads diferently then we’re used
to!). The conclusion is sufcient to know what its about (because it’s in
conformity with other litarture we have).
The therapeutic alliance has a long history in the child and adolescent psychotherapy
literature. This article examines prominent views on the alliance with youth and
considers a number of issues that distinguish youth alliance from its adult counterpart.
A meta-analysis of alliance– outcome associations in individual youth therapy is
presented. In order to provide a direct comparison with the adult literature, the review
included only prospective studies of individual youth therapy that used an explicit
measure of alliance. Results from 16 studies revealed consistency with the adult
literature with a weighted mean correlation of .22 (k = 16, n = 1306, p < .001)
between alliance and outcome (CI = + /- 06). Although there were trends showing
stronger alliance– outcome associations for child versus adolescent therapy and for
behavioral versus nonbehavioral therapies, only problem type (substance abuse and
mixed problems vs. eating disorders) signifcantly moderated alliance– outcome
associations. Limitations of the research and implications for therapeutic practice are
discussed.
Defnitions and Measures
The child’s experience of the therapist as supportive, attuned, and nonjudgemental is
privotal for therepeutic change. Therapy was not conceptualized as treatment, as
something you do to the child, but rather as an opportunity for growth.
Common to the foregoing perspectives is an emphasis on an emotional connection
between child and therapist. Emotional bond, then, appears to be a core component of
alliance with childeren. Some have criticized this perespective for failing to
acknowledge the social contractual features of the therapeutic alliance. From this
perspective, a central component of alliance, exspecially with older childeren and
adolescents, consists of agreements regarding treatment goals and the methods for
accomplishing them. Ohters have shown that emotional bond and task collaboratino
represent distinct but correlated alliance dimensions.
Developmental Considerations
Across the dimensions of bond, task, and goals, youth and adult alliance are
distinguished by a number of developmental factors.
The frst therapy bond:
Anna Freud (1964) noted that a child’s relationship with the therapist could arise from
a number of sources, not all of them developmentally equivalent. For may childeren,
the relationship with a therapist is an opportunity to fulfll needs not available in ohter
contexts. In the latter, the therapeutic bond is based on experiencing the therapist as
someone who can be counted on for help with emotional or behavioral problems.
Although the bond may be closely linked with this function in adult therapy, is cannot
ben assumed with youth.
The second developmental issue concerns the task dimension of alliance. For example,
children’s causal reasoning may limit their ability to understand links between specifc
therapy tasks and subsequent therapy goals. Such developmental concerns have
Psychotherapy
Diagnostiek deel B (page 17-24).
It’s a meta-analysis instead of the study itself (reads diferently then we’re used
to!). The conclusion is sufcient to know what its about (because it’s in
conformity with other litarture we have).
The therapeutic alliance has a long history in the child and adolescent psychotherapy
literature. This article examines prominent views on the alliance with youth and
considers a number of issues that distinguish youth alliance from its adult counterpart.
A meta-analysis of alliance– outcome associations in individual youth therapy is
presented. In order to provide a direct comparison with the adult literature, the review
included only prospective studies of individual youth therapy that used an explicit
measure of alliance. Results from 16 studies revealed consistency with the adult
literature with a weighted mean correlation of .22 (k = 16, n = 1306, p < .001)
between alliance and outcome (CI = + /- 06). Although there were trends showing
stronger alliance– outcome associations for child versus adolescent therapy and for
behavioral versus nonbehavioral therapies, only problem type (substance abuse and
mixed problems vs. eating disorders) signifcantly moderated alliance– outcome
associations. Limitations of the research and implications for therapeutic practice are
discussed.
Defnitions and Measures
The child’s experience of the therapist as supportive, attuned, and nonjudgemental is
privotal for therepeutic change. Therapy was not conceptualized as treatment, as
something you do to the child, but rather as an opportunity for growth.
Common to the foregoing perspectives is an emphasis on an emotional connection
between child and therapist. Emotional bond, then, appears to be a core component of
alliance with childeren. Some have criticized this perespective for failing to
acknowledge the social contractual features of the therapeutic alliance. From this
perspective, a central component of alliance, exspecially with older childeren and
adolescents, consists of agreements regarding treatment goals and the methods for
accomplishing them. Ohters have shown that emotional bond and task collaboratino
represent distinct but correlated alliance dimensions.
Developmental Considerations
Across the dimensions of bond, task, and goals, youth and adult alliance are
distinguished by a number of developmental factors.
The frst therapy bond:
Anna Freud (1964) noted that a child’s relationship with the therapist could arise from
a number of sources, not all of them developmentally equivalent. For may childeren,
the relationship with a therapist is an opportunity to fulfll needs not available in ohter
contexts. In the latter, the therapeutic bond is based on experiencing the therapist as
someone who can be counted on for help with emotional or behavioral problems.
Although the bond may be closely linked with this function in adult therapy, is cannot
ben assumed with youth.
The second developmental issue concerns the task dimension of alliance. For example,
children’s causal reasoning may limit their ability to understand links between specifc
therapy tasks and subsequent therapy goals. Such developmental concerns have
