Therapist's effect on children's therapeutic alliance: A naturalistic study

Abstract

AbstractObjectivesThe therapeutic alliance (TA) has been shown to be a predictor of psychotherapy treatment success. In the case of psychotherapy with children, there is a dearth of information on TA´s role. The aims of the paper are: (1) To estimate the therapist effects on children TA; (2) to investigate if therapists´ TA predicts children´s TA; (3) to analyze if children´s age and sex predict children´s TA; (4) to evaluate if the therapist´s characteristics predict children´s TA.MethodsThe sample consisted of 77 children undergoing psychotherapy in Argentina, and the therapists (N = 29) providing services to those children. The assessment tools utilized for the study included the Therapy Alliance Scale for Children and the Personal Style of the Therapist Questionnaire (PST-Q).ResultsFindings indicated that 2% of the children´s TA was explained by the therapists (ICC = 0.02), while 17% of the therapists´ TA was explained by the therapists (ICC = 0.17). Therapists´ TA predicted children´s TA. Children´s age and sex did not have an effect on their own TA. Moreover, therapists with more experience achieved higher scores of children´s TA. Finally, the Operative dimension of the PST had a negative effect on children´s TA (i.e., therapists who prefer more spontaneous interventions over structured ones may experience higher levels of therapeutic alliance with child patients).ConclusionWe found a positive effect of the therapist´s TA on children´s TA, especially in the preference for using more spontaneous intervention techniques. We discuss the implications of the findings on the training of psychotherapists who provide services to children.