Alliance in Child and Adolescent Psychotherapy

Marc S. Karver, Alessandro S. De Nadai, Maureen Monahan and Stephen R. Shirk

in Psychotherapy Relationships that Work

Third edition

Published on behalf of John C. Norcross

Published in print June 2019 | ISBN: 9780190843953
Published online May 2019 | e-ISBN: 9780190844011 | DOI:
Alliance in Child and Adolescent Psychotherapy

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In youth treatment, the alliance has been defined and measured as a consensual or collaborative bond. This chapter reviews varied definitions of the alliance, enumerates its frequent measures, and presents clinical examples. The authors provide a meta-analytic review on the relation between the therapeutic alliance and treatment outcome in child and adolescent psychotherapy. The meta-analysis of 43 studies revealed a weighted random effect size of r = .20, which is a small to medium effect consistent with the adult alliance literature and with prior youth meta-analyses. Multiple moderators of the alliance–outcome association were found, including diagnosis class, study design, and outcome rater. Research limitations, patient contributions, and diversity considerations follow. The chapter concludes with research-informed practices for building and maintaining the therapeutic alliance with youth.

Keywords: alliance; child; adolescent; psychotherapy; psychotherapy relationship; meta-analysis

Chapter.  16689 words.  Illustrated.

Subjects: Clinical Adult Psychology

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