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Irreducibly human encounters: therapeutic alliance and treatment outcome in child and adolescent psychotherapy
Cameron M. Clark
Journal of Infant, Child & Adolescent Psychotherapy, Informa, 2013, Volume 12 (3): 228–43
Background: The concept of therapeutic alliance is examined in relation to treatment outcomes in youth psychotherapy. The first section of the article develops an intuitive account wherein the relationship between the therapist and youth client is purported to hold great significance for treatment effectiveness in psychological interventions. The remainder of the article aims to validate this deep-rooted intuition via close examination of how therapeutic alliance has been defined, measured, and meta-analysed in the current literature. Methodological and philosophical challenges to the concept and implications for future research and practice are discussed. Cautious, but optimistic conclusions are drawn affirming the intuitive position that the relationship between therapist and youth client does indeed impact treatment outcome.
Secure attachment to therapist, alliance, and outcome in psychoanalytic psychotherapy with young adults
Peter Lilliengren, Fredrik Falkenström, Rolf Sandell, Pia Risholm Mothander & Andrzej Werbart
Journal of Counseling Psychology, American Psychological Association, 2014, Volume 62 (1): 1–13
Background: Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintaine