title: The therapeutic alliance in cognitive-behavioral treatment of children referred for oppositional, aggressive, and antisocial behavior.
abstract: The authors examined the therapeutic alliance in evidence-based treatment for children (N = 185, 47 girls, 138 boys; ages 3-14 years) referred clinically for oppositional, aggressive, and antisocial behavior. Different alliances (child-therapist, parent-therapist) were assessed from each participant's perspective at 2 points over the course of treatment. As predicted, both child-therapist and parent-therapist alliances related to therapeutic change, family experience of barriers to participation in treatment, and treatment acceptability. Greater alliance was associated with greater therapeutic change, fewer perceived barriers, and greater treatment acceptability. The findings could not be attributed to the influence of socioeconomic disadvantage, parent psychopathology and stress, and child dysfunction or to rater effects (common rater variance in the predictors and criteria).
authors.affiliation: Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA.
authors.forename: Alan E
authors.initials: AE
authors.lastname: Kazdin
authors.forename: Paul L
authors.initials: PL
authors.lastname: Marciano
authors.forename: Moira K
authors.initials: MK
authors.lastname: Whitley
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D000987:Antisocial Personality Disorder / Q000628:therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team; D011368:Professional-Family Relations; D012017:Referral and Consultation