Browsing by Subject "Therapeutic alliance"
Now showing 1 - 3 of 3
- Results Per Page
- Sort Options
Item Family peer advocates : strengthening the alliance among high need families and mental health providers(2019-11-13) Jamison, Jesslyn M.; Bearman, Sarah KateFamily Peer Advocates (FPAs) are one type of peer-to-peer support proposed to help address unmet mental health needs of children and families and augment mental health treatment. This study examined whether FPA support predicted child mental health symptoms and therapeutic alliance with mental health providers at the end of mental health treatment for a sample of families in a larger effectiveness trial (N = 114) who elected to have support from a FPA (n= 76) and families who did not (n = 38). Study participants were primarily Caucasian/European(79.8%) and Child Welfare referred (75%). Additionally, this study examined whether being referred for treatment by Child Welfare moderated the relationship between FPA support and changes in child symptoms and parental therapeutic alliance with a mental health provider. Results indicated that FPA support did not predict child symptoms at end of outpatient mental health treatment or parent rating of therapeutic alliance in the sample as a whole. Child Welfare referral status moderated the relationship between FPA support and parental ratings of therapeutic alliance. Support from an FPA was a significant predictor of parental ratings of therapeutic alliance for families who were referred to treatment by Child Welfare (b = 3.88, t = 2.48, p = 0.015, ηp2 = .077), suggesting that FPA support may augment the therapeutic alliance with outpatient mental health provider for highly strained families. Keywords: Family Peer Advocate; Child Mental Health; Therapeutic Alliance; Child WelfareItem Navigating two alliances with evidence-based practices : relating therapist competence and adherence to youth and caregiver therapeutic alliances(2018-08-14) Woo, Rebecca Yao Hay; Bearman, Sarah KateDespite extensive research on specific treatments and relationship factors in child and adolescent psychotherapy, comparatively little research has addressed in-session process variables concerning how a treatment is delivered. This study examines treatment integrity (therapist adherence and competence) in the delivery of evidence-based practice (EBP) elements and the two therapeutic alliances in youth psychotherapy: the youth-therapist alliance and the caregiver-therapist alliance. Data come from an initial test of a modular, trans-diagnostic therapy protocol of EBP elements with 14 therapists seeing 24 clients and were analyzed using Hierarchical Linear Modeling (HLM). Therapist adherence, competence, and alliance were all measured observationally. In this sample, therapist adherence contributed a small, statistically trending effect on child alliance (d [subscript wt] = 0.008, p = 0.055), while therapist competence did not predict child alliance. Therapist adherence exhibited a small, statistically significant effect on parent alliance (d [subscript wt] = 0.007, p = 0.023). Therapist competence exhibited a large, statistically trending effect on parent alliance (d [subscript wt] = 0.675, p = 0.059). Results suggest that EBP does not harm the therapeutic alliance and may support a stronger alliance with caregivers. Future research should use larger samples to explore how these constructs interact with therapist, youth, and caregiver characteristics to produce outcomes.Item Working alliance, readiness for change, and theory of change as predictors of treatment success among incarcerated adolescents(2007) Savicki, Kristin Lindsay, 1976-; Guzmán, Michele R.The working alliance has been defined as a collaborative agreement between therapist and client on the goals and tasks of therapy, together with a bond of mutual trust (Bordin, 1979). The link between a strong working alliance and positive therapy outcomes has received widespread empirical support (Horvath & Symonds, 1991; Horvath & Luborsky, 1993). In light of this robust finding, Duncan and Miller (2000) suggest that, to increase their effectiveness, therapists may attend to and work within "the client's theory of change." These findings and suggestions typically concern the adult client willingly attending therapy. This study investigated how they might apply to juvenile delinquents. The goal of the current study was to examine the relationship between working alliance and treatment outcomes with delinquent youth. In addition, it aimed to investigate an element of the working alliance suggested to be of particular importance to these youth, their perception that the treatment process "fits" their own theory of change. Given its impact on treatment of mandated clients, readiness for change was also examined for its relationship with working alliance and treatment outcomes. One hundred and fourteen incarcerated youth were asked to complete a series of surveys at baseline, 2-month, and 4-month follow-up. The relationship between the predictor variables (working alliance, readiness for change, treatment fit with change theory) and criterion variables (staff-rated treatment progress, rule violations, and predicted post-detention success) were examined with multiple regression. Results demonstrated that youths' baseline ratings of treatment fit with change theory predicted self-reported treatment progress 4 months later, even when controlling for readiness for change. Treatment fit with change theory was related to the working alliance in this sample, and was a better predictor of self-reported treatment gains than the working alliance. Results suggest that treatment fit with change theory may be a productive way to conceptualize the alliance construct in work with incarcerated youth. Qualitative data on theories of change was elicited from participants and content analyzed for themes. Contributions to the developing field of desistence theory and implications for clinical practice are discussed.