How Intervention Format and Therapist-Child Agreement Affect Therapeutic Alliance and Outcomes

Intervention Format and Therapist-Child Agreement Associated With Therapeutic Alliance and Outcome

Journal of Consulting and Clinical Psychology, 2024
 

The quality of the  therapeutic relationship can make or break a child’s progress in therapy. But what happens when therapy is delivered in a group setting versus a one-on-one environment— especially for children with aggressive behaviors and conduct problems? Despite the widespread use of group therapy for these children,  research has not yet clarified whether the same strong therapeutic alliance can be built in group formats as in individual therapy. This new study dives into exactly that, shedding light on a critical factor often overlooked in clinical practice.

A stronger therapeutic alliance in individual CBT for children with externalizing behaviors (i.e., oppositional and antisocial behavior) is known to predict stronger therapeutic change. 

This study addresses two dimensions of therapeutic alliances – relational bond and task collaboration. The findings offer new insights into how these aspects of therapeutic alliances relate to behavioral adjustments in children with aggressive behavior problems and how they may develop and operate differently in small group versus individual formats.

The results of this study underscore the important role of relational bond and task collaboration in predicting greater reductions of externalizing and internalizing problems following CBT interventions.  
 

Highlights from the Study

“Therapeutic alliance remains an important additional predictor of children’s later behavior. Thus, therapeutic alliance should be an important consideration in CBT with aggressive youth . . .”

“Relational bond and task collaboration are important in group therapy as well as in individual sessions. These findings are evident in a sample of children with aggressive behavior problems who are at-risk for escalating externalizing behavioral problems and collateral internalizing problems over time, if left untreated.”

“Reductions in children’s externalizing and internalizing problems were found to be evident when the child developed a positive emotional connection with the therapist and when they could potentially talk in collaborative ways about difficult feelings and engage in problem solving”

At Feeling Good Institute, we use an advanced form of empathy to create strong therapeutic bond and task collaboration with clients. Therapists at Feeling Good Institute use routine testing to ensure proper maintenance of the therapeutic alliance and positive connections with therapists, so that the Cognitive Behavioral interventions we deliver can be optimally effective.

Research Brief Author:  Arturo Figueroa, LCSW
 

Citation: Lochman, J. E., Laird, R. D., McDaniel, H. L., Boxmeyer, C. L., Braun, S. S., Powell, N. P., & Qu, L. (2024). Journal of Consulting and Clinical Psychology, Vol 92(1), Jan 2024, 26-43
https://doi.org/10.1037/ccp0000841