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Aschieri F, Cera G, Fiorelli E, Brasili S. A retrospective study exploring parents' perceptions of their child's assessment. Front Psychol 2024; 14:1271746. [PMID: 38415062 PMCID: PMC10897758 DOI: 10.3389/fpsyg.2023.1271746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/30/2023] [Indexed: 02/29/2024] Open
Abstract
The current study investigates parents' perceptions of their child's assessment, focusing on their responses to the Italian version of the Parents' Experience of Assessment Scale (QUEVA-G). Twenty parents, who voluntarily agreed to be contacted after completing the questionnaire, participated in qualitative interviews to gain deeper insights into their assessment experiences. A thematic analysis was conducted on the interview transcriptions, highlighting three primary domains of parental experience: (1) parental perceptions of the assessment process; (2) effects of the assessment; and (3) parental perceptions of their relationship with their children's teachers. The findings indicate that the QUEVA-G accurately captures most areas of interest as well as reveals unexplored aspects.
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Affiliation(s)
- Filippo Aschieri
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giulia Cera
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Sara Brasili
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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2
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Dimic T, Farrell A, Ahern E, Houghton S. Young people's experience of the therapeutic alliance: A systematic review. Clin Psychol Psychother 2023; 30:1482-1511. [PMID: 37537723 DOI: 10.1002/cpp.2885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE The aim of this systematic review was to synthesise qualitative evidence on young people's conceptualisation, utilisation and experiences of the therapeutic alliance in individual psychotherapy or counselling and its role in bringing about change. METHOD The thematic synthesis method was used to synthesise data. The methodological quality of included studies was assessed using the CASP checklist for qualitative research. RESULTS Four superordinate analytical themes were generated: (1) valuable therapist qualities, (2) conditions for the development and maintenance of the therapeutic alliance, (3) therapeutic processes and (4) barriers to the development of the therapeutic alliance. Findings indicate that young people appreciated the uniqueness of the therapeutic relationship that provided a sense of safety, choice and autonomy. Flexibility and accessibility were noted as important elements of therapeutic alliance building as they elicited a sense of agency. Young people emphasised the non-linear nature of therapy and prioritised process variables such as improvement in self-understanding, self-efficacy and self-worth. CONCLUSION The current systematic review is a comprehensive overview of qualitative studies of experiences of therapy from young people's perspectives. Important practical implications derived from this review as the role of autonomy in the change process and the formation and maintenance of the therapeutic relationship were outlined as important elements in youth therapy.
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Affiliation(s)
- Tamara Dimic
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Aoife Farrell
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Elayne Ahern
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Sharon Houghton
- Department of Psychology, University of Limerick, Limerick, Ireland
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Nilsson E, Olaison A. "I See What You Mean"-A Case Study of the Interactional Foundation of Building a Working Alliance in Care Decisions Involving an Older Couple Living with Cognitive Decline. Healthcare (Basel) 2023; 11:2124. [PMID: 37570364 PMCID: PMC10418874 DOI: 10.3390/healthcare11152124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Social workers have a key role in needs assessment meetings with families dealing with dementia, providing information, support, and advocacy, while also assessing needs and making decisions about care services for several parties. These contacts are especially important during the introduction of home care services, where often the person has previously relied on informal support from relatives. The needs assessment process entails the involvement of all present parties, with the aim to reach a mutual agreement, a working alliance, regarding which services to apply for. PURPOSE The aim of this case study is to explore how the participants, by means of different conversational practices, jointly create a working alliance between the different parties in one family. The study provides insights into the process of co-constructing a working alliance in the needs assessment process for elder care services. METHODS This article addresses the process by which social workers build a working alliance in a multi-party conversation with a family living with cognitive decline; a meeting that lasted 50 min. In this case study, we benefit from an inductive and detailed conversation analytic methodology. The theoretical framework of working alliances in institutional interaction has informed the analysis. RESULTS The findings illustrate how the social worker in this case study involves all parties in the decision regarding care services and explores the use of the conversational practices of mitigations, positive framing, adding information, and positioning, as a "we" achieve mutual agreement toward the end of several sequences. CONCLUSIONS Drawing on the results of this case study, we argue that multi-party interaction involving relatives enables diversity in role-taking, where the professional, for instance, can pursue a more empathic role. Also, our results indicate that minimal agreement to a proposal is sufficient in a multi-party interaction involving clients with cognitive decline.
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Affiliation(s)
- Elin Nilsson
- Division of Social Work, Department of Culture and Society, Linköping University, SE-601 74 Norrköping, Sweden;
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McElvaney R, Monaghan A, Treacy C, Delaney N. Adolescents' experiences of psychotherapy following child sexual abuse. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:630. [PMID: 37401470 PMCID: PMC10481422 DOI: 10.4081/ripppo.2023.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/06/2023] [Indexed: 07/05/2023]
Abstract
The aim of this study was to explore adolescents' experiences of psychotherapy following sexual abuse, complementing those studies that focus on outcomes and measurement of symptom change across the course of therapy and building on recent studies that focus on the process of psychotherapy for young people who have experienced sexual abuse, from their perspective. Recent reviews have highlighted the need for tailored approaches to therapy. Research is needed that focuses on young people's experiences of therapy to help develop such tailored approaches. In this study, 16 young people aged 15-18 years who were attending specialist sexual violence therapeutic services were interviewed. Using thematic analysis, six themes were identified as reflecting their experiences of therapy following sexual abuse. Young people spoke of not wanting to attend; the importance of choice and not feeling pressured in both initially attending and in how the therapy unfolded; how helpful it was to talk; the centrality of the relationship with their therapist; the benefit of attending a specialist service; how helpful it was when the therapist explained things; and finally, the coping skills they learned in the therapeutic work. A key learning from the study is the importance of respecting young people's autonomy following such violations of trust and psychological integrity. The study highlights how engagement in therapy may be experienced as a re-enactment of an experience that was forced on the young person. Further qualitative research exploring this phenomenon could guide therapists on how to minimise such re-enactments in therapeutic work.
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Orlowski EW, Bender AM, Karver MS. A systematic review and meta-analysis of clinician behaviors and characteristics related to alliance building with youth clients. Clin Psychol Rev 2023; 102:102273. [PMID: 37004422 DOI: 10.1016/j.cpr.2023.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 02/15/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023]
Abstract
The literature on developing alliance with youth clients has severely lagged behind that of adults. To date, there has been no meta-analytic review and limited qualitative synthesis of clinician variables which may contribute to the alliance with youth clients. Systematic literature search found a total of 49 relevant citations. Of the identified articles, 13 (27.08%) reported quantitative methods. Results of the qualitative review suggested that the majority of this research has focused on developing an emotional bond and a sense of collaboration. Meta-analysis found significant relations between alliance building and reducing variables and alliance (ralliance building = 0.17; ralliance reducing = -0.24). This analysis revealed specific behaviors particularly facilitative to youth alliance development, including collaborating with the client, finding common ground, exploring subjective experiences, orienting to treatment, providing praise, and enhancing facilitative conditions. In contrast, clinician lapse and pushing the client to talk were most predictive of a worse alliance. These results indicate certain behaviors which may be particularly important for clinicians to facilitate and not impair youth alliance formation. There is a need for greater youth alliance formation research to better determine how alliance formation may differ across stages of development and treatment modalities.
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Roest JJ, Welmers-Van de Poll MJ, Van der Helm GHP, Stams GJJM, Hoeve M. A Meta-Analysis on Differences and Associations between Alliance Ratings in Child and Adolescent Psychotherapy. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:55-73. [PMID: 35862768 DOI: 10.1080/15374416.2022.2093210] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The alliance in child and adolescent psychotherapy is widely recognized as an important factor in therapy. Studies on the alliance have increasingly focused on assessment of the alliance as a dyadic construct, measuring both client and therapist alliance ratings. However, cross-informant reports of the alliance in child psychotherapy have not yet been subjected to meta-analysis. Therefore, the present meta-analysis aims to increase knowledge on the degree of convergence and divergence between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy. METHODS A series of three-level meta-analyses of 78 studies was conducted to investigate differences and associations between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy. RESULTS Findings indicated that children and parents in general rated the alliance more positively than their therapists (d = 0.35, d = 0.72, respectively), and that child-therapist and parent-therapist alliance ratings were moderately correlated (r = .32, r = .23, respectively). Associations between child and therapist ratings and observer ratings were moderate to large (r = .43, r = .53, respectively). CONCLUSIONS It can be concluded that children and parents generally report more positively on the alliance compared to their therapists, which is consistent with research on the alliance in adult populations. The small to moderate associations between alliance ratings indicate that individuals to some extent have a shared perspective on their alliance, and that the various perspectives on alliance should be acknowledged when dealing with children and parents in therapy. Implications for future research are discussed.
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Affiliation(s)
- Jesse J Roest
- Department of Social Work and Applied Psychology, University of Applied Sciences Leiden
| | | | - G H Peer Van der Helm
- Department of Social Work and Applied Psychology, University of Applied Sciences Leiden.,Research Institute Child Development and Education, University of Amsterdam
| | | | - Machteld Hoeve
- Research Institute Child Development and Education, University of Amsterdam
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Gabriel-Vacher N, Miranda I, Olhaberry M, Capella C, Morán-Kneer J, Núñez L, Alamo N, Meza C. The adverse childhood experiences of caregivers of children who have been victims of sexual assault: their relationship with the parental alliance in child psychotherapy ( Experiencias adversas tempranas de cuidadores de niños/as que han sido víctimas de agresiones sexuales: su relación con la alianza parental en la psicoterapia infantil). STUDIES IN PSYCHOLOGY 2022. [DOI: 10.1080/02109395.2022.2139347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Bate J, Tsakas A. Facilitative interpersonal skills are relevant in child therapy too, so why don’t we measure them? RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2022; 25. [PMID: 35532023 PMCID: PMC9153756 DOI: 10.4081/ripppo.2022.595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/05/2022] [Indexed: 12/30/2022]
Abstract
One of the consistent findings from psychotherapy process research has been the impact of therapist effects on patient change and the therapeutic alliance. The Facilitative Interpersonal Skills (FIS) paradigm is a task in which participants respond to standardized videos of actors playing patients in interpersonally challenging moments as if they were the therapist, which was designed to assess therapist effects. Participants’ video recorded responses are coded for eight skills: verbal fluency, emotional expressiveness, warmth/acceptance/understanding, empathy, persuasiveness, hope/positive expectations, alliance-bond capacity, and rupture-repair responsiveness. Performance-based procedures like the FIS minimize self-report bias and systematically control for client-related variability while maintaining strong clinical relevance. Research has shown that therapist FIS predicts the quality of the therapeutic alliance and outcome in adult psychotherapy. This paper describes the development and first adaptation of the FIS task using child and adolescent patients as the stimuli, and reports findings from a pilot study testing the reliability. The FIS-Child (FIS-C) task was administered to 10 therapists with a range of clinical backgrounds. Participants also completed the original FIS task and self-report measures of their empathy, social skills, and playfulness. Adequate interrater reliability was achieved on the FIS-C. There were no significant differences between participants’ ratings on the FIS-C compared to the original FIS, although there were minor differences in the correlations between the FISC and self-report measures compared to the original FIS. Findings support moving forward with utilizing the FIS-C to empirically study therapist effects that may be common factors across treatment models.
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Nuñez L, Fernández S, Alamo N, Midgley N, Capella C, Krause M. The therapeutic relationship and change processes in child psychotherapy: a qualitative, longitudinal study of the views of children, parents and therapists. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2022; 25. [PMID: 35373965 PMCID: PMC9153753 DOI: 10.4081/ripppo.2022.556] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 02/24/2022] [Indexed: 11/23/2022]
Abstract
Through the perspectives of children, parents and therapists, this study explored the therapeutic relationship as a change facilitator in different moments of psychotherapy. The children, parents, and therapists (N=15) who formed part of five therapeutic treatments were studied using a qualitative, longitudinal design. Thirty semi-structured interviews were done; half at the beginning and half after four months of psychotherapy. Children’s drawings were incorporated, and data were analysed through grounded theory methods and qualitative analysis guidelines for drawings. Participants identified several aspects of the therapeutic relationship as change facilitators. From the first encounters, the therapists’ close and adaptable attitude promoted an improved motivation for psychotherapy and enhanced engagement among children and parents. Later in the process, a positive, child-centred and affective therapeutic relationship fostered the child’s trust with the therapist as well as a positive relational experience, promoting associated changes in children and the development of socio-affective tools. Parents and therapists saw their own relationship as a change facilitator, as well as a broader understanding in parents of their children and an improved relationship with them. Parent’s and child’s changes helped each other. Specific and common aspects between participants’ perspectives provided a richer understanding of the studied phenomena. This study supports the view that a positive therapeutic relationship facilitates early changes in the motivation of children and parents, and provides them with a healing, relational experience as it develops. A positive parent-therapist relationship is also key for changes to further progress.
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Martinez RG, van Dyk IS, Kroll JL, Emerson ND, Bursch B. Recommendations for building telemental health relationships with youth: A systematic review and resource for clinicians. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:349-362. [PMID: 36248612 PMCID: PMC9562612 DOI: 10.1080/23794925.2021.1970050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ruben G. Martinez
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Ilana Seager van Dyk
- Department of Social & Behavioral Science, Yale School of Public Health, New Haven, CT
| | - Juliet L. Kroll
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TC
| | - Natacha D. Emerson
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Brenda Bursch
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA,Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA
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11
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Gilson ML, Abela A. The Therapeutic Alliance with Parents and their Children Working Through a Relational Trauma in the Family. CONTEMPORARY FAMILY THERAPY 2021; 43:343-358. [PMID: 34690425 PMCID: PMC8524226 DOI: 10.1007/s10591-021-09607-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/04/2022]
Abstract
This study is about how a therapeutic alliance is created and maintained with parents and their children working through a relational trauma. A case study design with narrative analysis as a method of research (Riessman, 2008) and a narrative approach of storying stories, inspired by McCormack (2000), is used. The participants of this study are the parents and their four children, aged between 14 and 5 years, and their systemic therapist. Rich data on the therapeutic alliance is gathered through, two live-family session observations and seven interviews, six of which were with the family members, and a two-part interview held with their therapist. Results show that the way of being of the therapist, including her ability to be intuitive and self-reflexive, and her ability to keep manoeuvrability in conversation and hold neutrality support her to connect with all the family. Creating conjoint and separate therapeutic spaces, using a creative play-based approach and navigating an alliance with the school and medical professionals, were important suggestions for practice in the field. Additionally, collaborating with parents, and balancing the benefits and drawbacks of involving children to make therapy meaningful for all, are also suggested. Specific recommendations for engagement with siblings of the identified-problem child are elicited. The strength of this study is that children’s voices, along with those of their parents’ and their systemic therapist are reported. Suggestions for practice to support children and their families who are working through a relational trauma are brought forward.
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Affiliation(s)
| | - Angela Abela
- Department of Family Studies, University of Malta, Msida, Malta
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12
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Núñez L, Midgley N, Capella C, Alamo N, Mortimer R, Krause M. The therapeutic relationship in child psychotherapy: integrating the perspectives of children, parents and therapists. Psychother Res 2021; 31:988-1000. [PMID: 33509052 DOI: 10.1080/10503307.2021.1876946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
This study addresses the therapeutic relationship in child psychotherapy, through an exploration of the experience of the main actors engaged in child psychotherapy. To describe and analyse the therapeutic relationship integrating the views of children, parents and therapists. This study employs a qualitative methodology, assuming a discovery-oriented approach which draws from grounded theory. Twelve psychotherapy triads participated, composed of children aged 6-10, their parents and psychotherapists. Semi-structured follow-up interviews were conducted (N=36), including a drawing in the case of the children. A positive therapeutic relationship with children and parents was viewed as a gradually constructed process, based on a positive emotional encounter between participants. It was facilitated primarily by the therapist's commitment and playful stance, the child and therapist mutual involvement, and the parent's collaboration. These aspects entailed a trustful, validating and caring relationship, that shaped children and parents' motivations towards therapy and facilitated change. From a multiple-perspective approach, therapy was conceived as a relational experience. The development of positive relationships required different and evolving dispositions from therapy main actors. Therapists' genuine feelings and engagement in therapeutic activity seem central, underlining the importance of addressing relational aspects in child therapy research and training.
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Affiliation(s)
- Lucía Núñez
- Psychology Department, Pontifical Catholic University of Chile, Santiago, Chile.,Psychology Department, University of Chile, Santiago, Chile
| | - Nick Midgley
- Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud National Centre for Children and Families, London, UK.,Research Department of Clinical, Educational and Health Psychology, University College London (UCL), UK
| | | | - Nicolle Alamo
- Social Work School, Pontifical Catholic University of Chile, Santiago, Chile
| | - Rose Mortimer
- Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud National Centre for Children and Families, London, UK
| | - Mariane Krause
- Psychology Department, Pontifical Catholic University of Chile, Santiago, Chile
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Dravsnik J, Signal T, Canoy D. Canine co‐therapy: The potential of dogs to improve the acceptability of trauma‐focused therapies for children. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Janene Dravsnik
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia,
| | - Tania Signal
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia,
| | - Doreen Canoy
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia,
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14
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Malhotra S, Chauhan N. The therapeutic alliance between the child, parents, and health professionals. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:323-332. [PMID: 32977888 DOI: 10.1016/b978-0-444-64148-9.00023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Therapeutic alliance (TA), a term first used by Zetzel (1956), refers to the collaborative relationship between a patient and a therapist, leading to the development of an affective bond during the process of treatment/therapy and an agreement on treatment/therapy-related tasks and goals. Over time, it became clear that therapeutic alliance has a bidirectional nature, not unique to any one form of therapy but universal in all forms of helping relationships. Engagement of both patient and therapist is essential to its development. Trust, empathy, acceptance, and honesty are among the many constituents of a TA. Alongside this, characteristics of healthcare professionals influence TA, with a warm, empathic, gentle, and accepting therapist enhancing positive TA and a rigid, critical, and less involved therapist posing a hindrance to the development of TA. Literature is sparse for TA in children, and it also essentially involves multiple relationships, namely child alliance, caregiver alliance, and child-parent relationship, which need to be taken into account. Developmental aspects should also be kept in mind while dealing with children and adolescents. It is seen that a strong and positive caregiver alliance influences the development of child alliance. There are ways to foster TA with the child and parent/caregiver to maximize benefits from therapy.
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Affiliation(s)
- Savita Malhotra
- Department of Psychiatry and Child and Adolescent Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Nidhi Chauhan
- Department of Psychiatry, Government Medical College & Hospital, Chandigarh, India
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Brouzos A, Vassilopoulos SP, Baourda VC. Development and Preliminary Examination of the Psychometric Properties of the Psychoeducational Group Alliance Scale for Children (PGAS-c) in Two Samples of Children Participating in Groups. JOURNAL FOR SPECIALISTS IN GROUP WORK 2018. [DOI: 10.1080/01933922.2018.1433257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Clarke A, Meredith PJ, Rose TA, Daubney M. A role for epistemic trust in speech-language pathology: A tutorial paper. JOURNAL OF COMMUNICATION DISORDERS 2018; 72:54-63. [PMID: 29471178 DOI: 10.1016/j.jcomdis.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 01/12/2018] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
This paper provides an introduction to epistemic trust for speech-language pathologists (SLPs). 'Epistemic trust' describes a specific form of trust that an individual places in others when learning about the world, particularly the social world. To date, the relevance of epistemic trust to SLP clinical practice has received little theoretical or empirical attention. The aim of this paper is to define epistemic trust and explain its relationship with parent-child attachment and mentalization which have, in turn, been linked with language development and use. Suggestions are made for ways in which SLPs may encourage epistemic trust in clients, emphasizing the need to establish strong therapeutic alliances. The authors conclude that epistemic trust is an important consideration for SLPs and that further research exploring the relationship between epistemic trust and language skills is needed to better understand the interplay of these variables and inform clinical practice.
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Affiliation(s)
- Angela Clarke
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Pamela J Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael Daubney
- Children's Health Queensland Hospital and Health Service, Queensland Health, Queensland, Australia
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Altimir C, Capella C, Núñez L, Abarzúa M, Krause M. Meeting in difference: Revisiting the therapeutic relationship based on patients' and therapists' experiences in several clinical contexts. J Clin Psychol 2017; 73:1510-1522. [PMID: 28881027 DOI: 10.1002/jclp.22525] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite decades of research on the therapeutic relationship and the therapeutic alliance and their connection with therapeutic outcomes (Horvath, Del Re, Flückiger, & Symonds, 2011), only a handful of studies have examined how they are experienced by the therapy participants. The aim of the present study is to describe the therapeutic relationship from the subjective perspective of the patients and therapists involved in 3 clinical cases: (a) a 7-year-old child diagnosed with attention deficit hyperactivity disorder, (b) a 29-year old woman diagnosed with a personality disorder, and (c) a 22-year-old man diagnosed with schizophrenia. We conducted semistructured interviews with patients and therapists that were later analyzed following grounded theory coding procedures (Corbin & Strauss, 2008). The results obtained reveal that the constitutive elements of the therapeutic relationship are linked to 2 dimensions of the patient-therapist meeting experience: the technical and role-related dimension, characterized by relational asymmetry, and the affective exchange dimension, characterized by relational symmetry. The article discusses the possible association between the asymmetrical technical dimension, whose roles are defined by the organization of the helping relationship, and the notion of therapeutic alliance as commonly conceptualized and assessed; on the other hand, the experience of the bidirectional and symmetrical patient-therapist affective exchange is linked with concepts such as real relationship and intersubjectivity.
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Affiliation(s)
- Carolina Altimir
- Universidad de Las Américas.,Pontificia Universidad Católica de Chile
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18
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Labouliere CD, Reyes JP, Shirk S, Karver M. Therapeutic Alliance With Depressed Adolescents: Predictor or Outcome? Disentangling Temporal Confounds to Understand Early Improvement. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:600-610. [PMID: 26042461 DOI: 10.1080/15374416.2015.1041594] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Psychotherapy research reveals consistent associations between therapeutic alliance and treatment outcomes in the youth literature; however, past research frequently suffered measurement issues that obscured temporal relationships between alliance and symptomatology by measuring variables later in therapy, thereby precluding examination of important early changes. The current study aimed to explore the directions of effect between alliance and outcome early in therapy with adolescents by examining associations between first- and fourth-session therapeutic alliance and symptomatology. Thirty-four adolescents (∼63% female, 38% ethnic/racial minority) participated in a school-based cognitive-behavioral therapy for adolescents with depression. Participants completed the Beck Depression Inventory at baseline and Session 4, and therapeutic alliance was coded from audiotapes of Sessions 1 and 4 by objective coders using the Alliance Observation Coding System. Autoregressive path analyses determined that first-session therapeutic alliance was a strong significant predictor of Session 4 depression symptoms, but pretreatment depression scores were not significantly predictive of subsequent therapeutic alliance. Adding reciprocal effects between alliance and depression scores did not adversely affect model fit, suggesting that reciprocal effects may exist. Early therapeutic alliance with adolescents is critical to fostering early gains in depressive symptomatology. Knowing alliance's subsequent effect on youth outcomes, clinicians should increase effort to foster a strong relationship in early sessions and additional research should be conducted on the reciprocal effects of therapeutic alliance and treatment outcome in adolescence.
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Affiliation(s)
- Christa D Labouliere
- a Division of Child & Adolescent Psychiatry , New York State Psychiatric Institute at Columbia University Medical Center
| | - J P Reyes
- b Outpatient Department , New York-Presbyterian Hospital - Westchester Division
| | | | - Marc Karver
- d Department of Psychology , University of South Florida
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