Child-therapist and parent-therapist alliance and therapeutic change in the treatment of children referred for oppositional, aggressive, and antisocial behavior.
BACKGROUND
We examined the therapeutic alliance in evidence-based treatment for children (N = 77, 19 girls, 58 boys, ages 6-14) referred clinically for oppositional, aggressive, and antisocial behavior.


METHODS
Different alliances (child-therapist, parent-therapist) were assessed from each participant's perspective at two points over the course of treatment. Both the quality of the child-therapist and the parent-therapist alliance predicted therapeutic changes in the children; the parent-therapist alliance also predicted improvements in parenting practices in the home.


RESULTS
The findings could not easily be attributed to the influence of other domains (socioeconomic disadvantage, parent psychopathology and stress, and severity of child dysfunction) known to predict therapeutic change or to rater effects (common rater variance) in the predictors and criteria.


CONCLUSIONS
The therapeutic alliance warrants increased attention to understand the precise role in treatment and whether or how the alliance can be mobilized to enhance change.
Kazdin
Alan E
AE
Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06520-7900, USA.
Whitley
Moira
M
Marciano
Paul L
PL