Therapeutic alliance in family-involved treatment, multi-problem families and problematic adolescents.

 

Submission type

Symposium

Scheduled

Parallel Session V: Mendes da Costa kamer, 09-06-2018, 09:00 - 10:30

Kernwoorden

therapeutic-alliance, families, adolescents, family-therapy, meta-analysis

Onderzoeksgebied

Therapeutic relationship

Beknopte samenvatting van de totale bijdrage

Effective treatment consists –among other factors- of a strong therapeutic alliance. Building alliances with adolescents and families can be particularly challenging. This symposium is an interesting mix of theoretic contributions in a meta-analysis on alliance in family-involved treatment and two clinical studies on alliance with multi-problem families and problematic adolescents.

Auteurs

The effect of the quality of the therapeutic relationship on family functioning in multi-problem families.

Gudde, L.M. (Liesbeth), Overbeek, M.M., Rijnberk, C., Maras, A.

 

Abstract ID

1222

Submission type

Oral only

Introductie

An important factor in the treatment of multi-problem families is the therapeutic relationship, which has been found to be a predictor of therapy outcomes (e.g. Bachler et al., 2016). We studied the effect of the quality of the therapeutic relationship between therapists and multi-problem families on family dysfunctioning throughout therapy.

Materiaal en methodes

Therapeutic relationship between multi-problem families and therapists was measured with the System of Observing Family Therapy Alliance (SOFTA; Friedlander et al., 2006). Family dysfunctioning was measured with the Family Assessment Device (FAD; Epstein et al., 1983).

Resultaten

Family dysfunctioning was negatively related with engagement in the therapeutic process at the start of the therapy (r=-.302, p = .033). Growth in family’s engagement in the therapeutic process was positively related to a decrease in family dysfunctioning over the course of treatment (r =.382, p = .006).

Conclusie

Based on these results, we can conclude that when a family presents more problems at the start of treatment it is more difficult to become engaged in the therapy-process. However, when families are able to get involved in treatment they benefit more and family functioning increases. This summer results [currently being coded] will also be presented on the influence of therapist attachment on the therapeutic relationship.

Auteurs

Early alliance and treatment outcome in children with internalizing versus externalizing disorders

Liber, J. (Juliette), Vuijk, P. (Patricia), Groot-Zijlstra, E. de (Esther), Boo, G. de (Gerly)

 

Abstract ID

1223

Submission type

Oral only

Introductie

Results from meta-analyses showed positive (but small) associations between therapeutic alliance and treatment outcome. Findings vary for children with internalizing versus externalizing behaviour problems suggesting that therapeutic alliance is of greater impact upon outcome for children with externalizing behaviour. The aim of this study is to investigate the alliance-outcome association of early therapeutic alliance in two treatment outcome studies including children aged 8-12 years with internalizing vs. externalizing problems.

Materiaal en methodes

Early alliance was examined in children (n = 52) with anxiety disorders who participated in a cognitive behavioural (CBT) intervention program using an observation approach. The same approach was used to examine early alliance in children (n = 44) with disruptive behaviour who participated in a CBT prevention program. The relationships between early alliance and outcome were assessed with regression analysis.

Resultaten

Parents and children reported significant decreases in internalizing problems and anxiety at post-treatment (Cohen’s d = 0,54). Early alliance did not predict treatment gains, not even marginally (r=.02). Parents and teachers reported significant decreases in disruptive behaviour at post-treatment (Cohen’s d = 0,31). Early alliance predicted treatment gains, though marginally (r=.31).

Conclusie

The results suggest that optimizing the therapeutic relation may enhance treatment gains especially in children with disruptive behaviour.

Auteurs

Our symposium consists of 3 presentations.

No, No (Presenter)

 

Abstract ID

1227

Submission type

Oral only

Auteurs

Alliance and treatment outcome in family-involved treatment: A three level meta-analysis

Welmers - van de Poll, J.M. (Marianne), Roest, J. J., Stouwe, T. van der, Akker, A. L. van den, Stams, G. J. J. M., Escudero, V., Overbeek, G. J., Swart, J. J. W. de

 

Abstract ID

1221

Submission type

Oral only

Introductie

Alliance has been shown to predict outcome in family-involved treatment for youth problems. However, building alliances with multiple family members in family-involved treatment raises several complexities, and meta-analytic research on alliance in family-involved treatment is scarce.

Materiaal en methodes

In our study, we included 28 studies reporting on the alliance - outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N = 2126 families). We performed multilevel meta-analyses of the associations between three types of alliance processes and outcome, and of several moderator variables.

Resultaten

The quality of the alliance was significantly associated with outcome (r = .183, p < .001), with stronger correlations when alliance scores of different measurement moments were averaged or added, when families were help-seeking rather than receiving mandated care, and when studies included younger adolescents. The correlation between alliance improvement and outcome just failed to reach significance (r = .281, p = .067), and no significant correlation was found between split alliances and outcome (r = .106, p = .343). However, the number of studies reporting on alliance change scores or split alliances was small.

Conclusie

Future research should focus on investigating the more complex dynamic and systemic aspects of alliance in family-involved treatment.

Auteurs