Yorkville University

Therapeutic Alliance: A Comparison Study between Adolescent Patients and Their Therapists

From Abstract, p. 1:

• Weak adolescent- or therapist-rated alliance later in treatment and change for the worse in adolescent-rated alliance was associated with treatment dropout.
• As adolescent-rated alliance predicts treatment outcome better than therapist-rated alliance, therapists should frequently use assessments of therapeutic relationship within the therapy and pay attention if the adolescent feels the alliance is weakening or his/her evaluation is contrary to the therapist’s.

From 1. Introduction, pp. 1-3:

• According to the so-called common factors model [8–10], there are factors that affect the treatment outcome regardless of the treatment modality.
• Common factors that have been found to have the largest effects include alliance, empathy, treatment expectations, cultural adaptation of the treatment, and therapist effects [10].
  • Alliance between the patient and the therapist has been described as the most important common factor related to good treatment outcome, despite the length or modality of the treatment
• A commonly used conceptualization of alliance in psychotherapy research literature is based on Bordin’s pantheoretical three-dimensional model
  • The model defines working alliance as the therapist–patient collaboration on the goals and tasks of treatment during the therapy process, and the bond developed between them to work toward the agreed goals.
  • The development of a “good enough” alliance early in therapy has been shown to be vital for the success of therapy, as it prevents patients from prematurely terminating treatment and enables a collaborative working space
• Alliance seems to develop by the third to fifth treatment session
• ...therapeutic alliance has been found to be an important treatment outcome predictor also with adolescents
  • Studies on youth alliance have failed to fully support the three-factor model, suggesting that features of the alliance are less differentiated at a younger age, and instead propose a single-factor solution
• In addition, there are several studies suggesting that it is, in fact, the change in alliance that best predicts the treatment outcome or treatment completion
• An ability to form and retain a positive working alliance might be even more crucial with adolescents than with adults, as adolescents are likely to have a more limited perception of psychotherapy and are typically referred for treatment by others