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Shapiro CJ, Hill-Chapman C, Williams S. Mandated Parent Education: Applications, Impacts, and Future Directions. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00488-1. [PMID: 38761324 DOI: 10.1007/s10567-024-00488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/20/2024]
Abstract
Mandated participation in parent education programs is a common practice across the United States for families who are undergoing divorce or who are involved in the child welfare or juvenile justice systems. Mandates to participate in parenting programs create substantial challenges for families, service providers, and service systems. Furthermore, the type and quality of the parenting services accessed vary widely, and their impacts need to be better understood. To address this need, an overview of the current state of the empirical literature on the impacts and outcomes of mandated parenting interventions for divorce and in child welfare and juvenile justice settings is provided, and suggestions to the field are offered to refine research related to mandated parenting programs. Given the challenges that mandated parenting programs pose, an alternative approach that views parenting through a public health lens is highlighted to build on the growing body of research on the impacts of population-wide applications of parenting support programs, and as a possible way to decrease the number of parents who are required to attend parenting programs. Opportunities to advance universal parenting support within a range of community settings, including primary care, early childhood education, and community mental health systems are offered. Gaps in knowledge regarding mechanisms of action of universal supports and impacts on the number of parents mandated to treatment are highlighted, and future directions for research in this area are suggested.
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Affiliation(s)
- Cheri J Shapiro
- Institute for Families in Society, College of Social Work, University of South Carolina, 1600 Hampton St., Suite 507, Columbia, SC, 29208, USA.
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2
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Niu Y, Guo X, Cai H, Luo L. The relation between family socioeconomic status and depressive symptoms among children and adolescents in mainland China: a meta-analysis. Front Public Health 2024; 11:1292411. [PMID: 38264252 PMCID: PMC10803464 DOI: 10.3389/fpubh.2023.1292411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024] Open
Abstract
Family socioeconomic status (SES) is widely believed to be associated with depressive symptoms in children and adolescents. The correlation between SES and depressive symptoms changes based on social culture and the economic development level. In China, which includes many children and adolescents, the magnitude of the relationship between SES and depressive symptoms and its potential moderators remains unclear. The current meta-analysis was conducted to determine the overall association between SES and depressive symptoms in children and adolescents in mainland China. We included 197 estimates in mainland China from 2000-2023. Among 147,613 children and adolescents aged 7-18 years, the results showed a weak but significant overall negative association between SES and depression (r = -0.076). Moderator testing showed that the composite SES indicator (r = -0.104) had a stronger association with depression than parental educational level (r = -0.065) and occupational status (r = -0.025) but not family income (r = -0.088). Additionally, the negative association between SES and depression became weaker over the past 20 years in China (β = 0.010). Furthermore, the magnitude of the relationship between SES and depression was stronger in West China (r = -0.094) than in Middle China (r = -0.065), but not East China (r = -0.075). These findings indicate that the relationship between SES and depression among children and adolescents in mainland China may vary based on social contexts. It is necessary to further explore the effect of these social factors and the underlying mechanisms.
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Affiliation(s)
- Yingnan Niu
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Xiaolin Guo
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - He Cai
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Liang Luo
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
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3
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Cunningham PB, Gilmore J, Naar S, Preston SD, Eubanks CF, Hubig NC, McClendon J, Ghosh S, Ryan-Pettes S. Opening the Black Box of Family-Based Treatments: An Artificial Intelligence Framework to Examine Therapeutic Alliance and Therapist Empathy. Clin Child Fam Psychol Rev 2023; 26:975-993. [PMID: 37676364 PMCID: PMC10845126 DOI: 10.1007/s10567-023-00451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/08/2023]
Abstract
The evidence-based treatment (EBT) movement has primarily focused on core intervention content or treatment fidelity and has largely ignored practitioner skills to manage interpersonal process issues that emerge during treatment, especially with difficult-to-treat adolescents (delinquent, substance-using, medical non-adherence) and those of color. A chief complaint of "real world" practitioners about manualized treatments is the lack of correspondence between following a manual and managing microsocial interpersonal processes (e.g. negative affect) that arise in treating "real world clients." Although family-based EBTs share core similarities (e.g. focus on family interactions, emphasis on practitioner engagement, family involvement), most of these treatments do not have an evidence base regarding common implementation and treatment process problems that practitioners experience in delivering particular models, especially in mid-treatment when demands on families to change their behavior is greatest in treatment - a lack that characterizes the field as a whole. Failure to effectively address common interpersonal processes with difficult-to-treat families likely undermines treatment fidelity and sustained use of EBTs, treatment outcome, and contributes to treatment dropout and treatment nonadherence. Recent advancements in wearables, sensing technologies, multivariate time-series analyses, and machine learning allow scientists to make significant advancements in the study of psychotherapy processes by looking "under the skin" of the provider-client interpersonal interactions that define therapeutic alliance, empathy, and empathic accuracy, along with the predictive validity of these therapy processes (therapeutic alliance, therapist empathy) to treatment outcome. Moreover, assessment of these processes can be extended to develop procedures for training providers to manage difficult interpersonal processes while maintaining a physiological profile that is consistent with astute skills in psychotherapeutic processes. This paper argues for opening the "black box" of therapy to advance the science of evidence-based psychotherapy by examining the clinical interior of evidence-based treatments to develop the next generation of audit- and feedback- (i.e., systemic review of professional performance) supervision systems.
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Affiliation(s)
- Phillippe B Cunningham
- Division of Global and Community Health, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 176 Croghan Spur Rd. Ste. 104, Charleston, SC, 29407, USA.
| | - Jordon Gilmore
- Department of Bioengineering, Clemson University, 401-3 Rhodes Research Center, Clemson, SC, USA
| | - Sylvie Naar
- Center for Translational Behavioral Science, Florida State University, 2010 Levy Avenue Building B, Suite B0266, Tallahassee, FL, USA
| | - Stephanie D Preston
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | - Catherine F Eubanks
- Gordon F. Derner School of Psychology, Adelphi University, One South Avenue, Garden City, NY, USA
| | - Nina Christina Hubig
- School of Computing, Clemson University, 1240 Supply Street, Charleston, SC, 29405, USA
| | - Jerome McClendon
- Department of Automotive Engineering, Clemson University, 4 Research Drive, Greenville, SC, USA
| | - Samiran Ghosh
- Department of Biostatistics and Data Science & Coordinating Center for Clinical Trials (CCCT), University of Texas School of Public Health, University Texas Health Sciences , RAS W-928, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Stacy Ryan-Pettes
- Department of Psychology and Neuroscience, Baylor University, One Bear Place #97334, Waco, TX, 76798, USA
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4
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Roest JJ, Welmers-Van de Poll MJ, Peer Van der Helm GH, Stams GJJM, Hoeve M. A Three-level Meta-analysis on the Alliance-Outcome Association in Child and Adolescent Psychotherapy. Res Child Adolesc Psychopathol 2023; 51:275-293. [PMID: 36394705 DOI: 10.1007/s10802-022-00986-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/18/2022]
Abstract
Previous meta-analyses have found small to moderate associations between child-therapist alliance and treatment outcomes. However, these meta-analyses have not taken into account changes in alliance (i.e., alliance shifts), alliance agreement (i.e., congruence or discrepancies between child-therapist ratings), and the role of alliance as a moderator in relation to treatment outcomes (i.e., an interaction effect of alliance and treatment condition on treatment outcomes). A series of multilevel meta-analyses of 99 studies was conducted to investigate several types of alliance-outcome associations in child and adolescent psychotherapy. Associations between child-therapist alliance and child outcomes (r = 0.17), changes in child-therapist alliance and child outcomes (r = 0.19), child-therapist alliance as a moderator of outcomes (r = 0.09), and parent-therapist alliance and child outcomes (r = 0.13) were small. Associations between child-therapist alliance agreement and outcomes (r = 0.21) and between parent-therapist alliance and parent outcomes (r = 0.24) were small to moderate. This meta-analysis provides the most updated and comprehensive overview of the alliance-outcome association in child and adolescent psychotherapy, showing that the alliance continues to show impact on treatment outcomes. Alliance research in youth psychotherapy has increasingly focused on several complex aspects of the alliance-outcome association, such as the role of changes in alliance, alliance discrepancies, client and therapist variability, and the reciprocal association between alliance and prior symptom change in relation to treatment outcomes. Implications for future research and clinical practice are discussed.
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Affiliation(s)
- Jesse J Roest
- University of Applied Sciences Leiden, Zernikedreef 11, 2300 AJ, Leiden, The Netherlands.
| | | | - G H Peer Van der Helm
- University of Applied Sciences Leiden, Zernikedreef 11, 2300 AJ, Leiden, The Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands
| | - Geert Jan J M Stams
- Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands
| | - Machteld Hoeve
- Research Institute of Child Development and Education, University of Amsterdam, P.O. Box 15780, 1001 NG, Amsterdam, The Netherlands
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Dambi JM, Mavhu W, Beji-Chauke R, Kaiyo-Utete M, Mills R, Shumba R, Muchemwa S, Musesengwa R, Verhey R, Abas M, Hirsch CR, Chibanda D. The impact of working alliance in managing youth anxiety and depression: a scoping review. NPJ MENTAL HEALTH RESEARCH 2023; 2:1. [PMID: 37520938 PMCID: PMC9885927 DOI: 10.1038/s44184-023-00021-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 01/17/2023] [Indexed: 01/31/2023]
Abstract
A working alliance (WA) is a multidimensional construct signifying a collaborative relationship between a client and a therapist. Systematic reviews of therapies to treat depression and anxiety, almost exclusively in adults, show WA is essential across psychotherapies. However, there are critical gaps in our understanding of the importance of WA in low-intensity therapies for young people with depression and anxiety. Here, we describe an initiative to explore the effect of WA on anxiety and depression outcomes in youth aged 14-24 years through a scoping review and stakeholders' consultations (N = 32). We analysed 27 studies; most were done in high-income countries and evaluated one-on-one in-person therapies (18/27). The review shows that optimal WA is associated with improvements in: relationships, self-esteem, positive coping strategies, optimism, treatment adherence, and emotional regulation. Young people with lived experience expressed that: a favourable therapy environment, regular meetings, collaborative goal setting and confidentiality were vital in forming and maintaining a functional WA. For a clinician, setting boundaries, maintaining confidentiality, excellent communication skills, being non-judgmental, and empathy were considered essential for facilitating a functional WA. Overall, a functional WA was recognised as an active ingredient in psychotherapies targeting anxiety and depression in young people aged 14-24. Although more research is needed to understand WA's influence in managing anxiety and depression in young people, we recommend routine evaluation of WA. Furthermore, there is an urgent need to identify strategies that promote WA in psychotherapies to optimise the treatment of anxiety and depression in young people.
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Affiliation(s)
- Jermaine M. Dambi
- Rehabilitation Sciences Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, PO Box AV178, Avondale, Harare, Zimbabwe
- Friendship Bench, 4 Weale Road, Harare, Zimbabwe
| | - Webster Mavhu
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), 4 Bath Road, Harare, Zimbabwe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA UK
| | | | - Malinda Kaiyo-Utete
- Mental Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe
| | - Rhiana Mills
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | | | - Sidney Muchemwa
- Rehabilitation Sciences Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, PO Box AV178, Avondale, Harare, Zimbabwe
- Friendship Bench, 4 Weale Road, Harare, Zimbabwe
| | | | - Ruth Verhey
- Friendship Bench, 4 Weale Road, Harare, Zimbabwe
| | - Melanie Abas
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Colette R. Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Dixon Chibanda
- Friendship Bench, 4 Weale Road, Harare, Zimbabwe
- Mental Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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6
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van Herwaarden A, Schuiringa H, van Nieuwenhuijzen M, Orobio de Castro B, Lochman JE, Matthys W. Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104296. [PMID: 35810544 DOI: 10.1016/j.ridd.2022.104296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects. AIMS The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF. METHODS AND PROCEDURES Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions. OUTCOMES AND RESULTS The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002). CONCLUSIONS AND IMPLICATIONS The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.
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Affiliation(s)
- Aniek van Herwaarden
- Radboud University, Programme of Learning and Plasticity, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Hilde Schuiringa
- Utrecht University, Department of Developmental Psychology, Utrecht, the Netherlands
| | - Maroesjka van Nieuwenhuijzen
- Expertise Center William Schrikker, Amsterdam, the Netherlands; University of Amsterdam, Research Institute Child Development and Education, Amsterdam, the Netherlands
| | - Bram Orobio de Castro
- University of Amsterdam, Research Institute Child Development and Education, Amsterdam, the Netherlands
| | - John E Lochman
- University of Alabama, Department of Psychology, Tuscaloosa, AL, USA
| | - Walter Matthys
- Utrecht University, Department of Clinical Child and Family Studies, Utrecht, the Netherlands
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7
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Kivlighan DM, Escudero V, Friedlander ML, Orlowski E. Illustrating systemic change in family therapy: How therapists' and clients' alliance perceptions codevelop over time. Psychother Res 2022; 32:1064-1075. [PMID: 35549823 DOI: 10.1080/10503307.2022.2071131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Research showing that caregivers', adolescents' and therapists' perceptions of the therapeutic alliance become more similar over time has not examined conceptual models, like emotional contagion and interdependence, that are theorized to account for this convergence. Objective: We modeled codevelopment in systemic family therapy to examine mutual influence and shared environment processes among the alliance perceptions of youth, caregivers, and therapists. Method: The self-report version of the System for Observing Family Therapy Alliances (SOFTA-s) was administered after sessions 3, 6 and 9-156 Spanish maltreating families and 20 therapists. Results: Using a triadic version of the repeated measures actor-partner interdependence analysis, a random intercepts cross-lagged panel model, we found significant effects of the shared environment and mutual influence in caregivers' and therapists' alliance scores over time, reflecting emotional contagion. Additionally, (i) therapists' alliance scores at session 6 significantly predicted youth alliance scores at session 9, and (ii) therapist alliance at session 6 significantly mediated the relationship between caregiver alliance at session 3 and youth alliance at session 9, suggesting that therapists bridge the caregiver's and youth's perceptions of the alliance. In successful (compared to unsuccessful) cases, therapists' alliance perceptions at session 6 positively influenced caregivers' alliance perceptions at session 9. Conclusion: Therapist's perceptions of the alliance can bridge differences in alliance perceptions of caregivers and adolescents resulting in greater similarity in alliance perceptions over time.
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Affiliation(s)
- Dennis M Kivlighan
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, MD, USA
| | | | - Myrna L Friedlander
- Department of Educational & Counseling Psychology, University at Albany/State University of New York, Albany, NY, USA
| | - Edmund Orlowski
- Department of Educational & Counseling Psychology, University at Albany/State University of New York, Albany, NY, USA
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8
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Myers C, Thompson G, Hughey L, Young JL, Rhon DI, Rentmeester C. An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach. Musculoskeletal Care 2022; 20:577-592. [PMID: 34984781 DOI: 10.1002/msc.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION/OBJECTIVES Therapeutic alliance (TA) is an integral part of building a patient and clinician relationship. TA begins at the initial encounter; however, the specific TA behavioural practices that are most impactful and linked to pain reduction and improved function remain unclear. The primary objective of this study was to explore physical therapist behaviours and interactions during the initial physical therapy evaluation and how they related to the patient's perception of TA. A secondary objective was to explore the relationship between TA, pain intensity, and function. METHODS A mixed methods study was conducted. Pain intensity, TA and self-reported function were assessed at three time points. Spearman's Rho (ρ) was used to quantify if there was an association between increased TA and function and reduced pain intensity, while a checklist of TA themes and behavioural practices was used for the qualitative analysis. RESULTS There was a statistically significant negative correlation between patient-perceived TA and pain intensity immediately after the initial evaluation (ρ = -0.39 [p = 0.048]). Behavioural practices associated with higher TA included information gathering, pausing to listen, using humour and transitions, and use of clarifying questions. Behavioural practices associated with patient-perceived lower TA interactions were lack of touch, the absence of pain neuroscience education, and not restating what the patient said during the interview. CONCLUSION This study highlights a relationship between TA and reduction of pain intensity after the initial evaluation and identifies key behavioural practices that could positively and negatively impact TA during the clinical encounter.
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Affiliation(s)
- Christina Myers
- Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA.,Physical Therapy Department, South College School of Physical Therapy, Knoxville, Tennessee, USA
| | - Glenn Thompson
- Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA.,Physical Therapy Department, South College School of Physical Therapy, Knoxville, Tennessee, USA
| | - Lindsey Hughey
- Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA.,Physical Therapy Department, South College School of Physical Therapy, Knoxville, Tennessee, USA
| | - Jodi L Young
- Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
| | - Daniel I Rhon
- Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA.,Department of Rehabilitation Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - Casey Rentmeester
- Doctor of Science in Physical Therapy Program, Bellin College, Green Bay, Wisconsin, USA
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Determinants and Outcomes of the Therapeutic Alliance in Treating Justice-Involved Youth: A Systematic Review of Quantitative and Qualitative Research. Clin Child Fam Psychol Rev 2022; 25:658-680. [PMID: 35972713 PMCID: PMC9622555 DOI: 10.1007/s10567-022-00407-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 01/28/2023]
Abstract
A large body of research supports the role of the therapeutic alliance in predicting positive change in psychotherapy. This systematic review examined determinants of alliance quality and its association with treatment outcomes in an under-served and under-researched population-justice-involved youth-with whom several challenges and contextual considerations arise that bear relevance to the alliance. The search strategy yielded 23 independent studies meeting eligibility criteria and describing diverse treatments: 14 quantitative records synthesized narratively and nine qualitative studies that underwent thematic analysis. A complex picture emerged, precluding firm conclusions about factors linked to enhanced alliances and the alliance-outcome relationship with justice-involved youth. Nevertheless, some promising findings were noted across quantitative studies, including potential treatment benefits related to alliance growth and creating positive alliances with caregivers. The review also highlighted the potential relevance of the young person's relationships with peers and parents and their treatment readiness and expectations to alliance quality. Drawing on adolescent, caregiver, and therapist perspectives, the thematic synthesis of qualitative studies generated themes related to key elements of constructive alliances and their role in creating a foundation for initiating change. An integrated discussion is provided, highlighting practical implications and suggestions for addressing methodological limitations and substantive knowledge gaps.
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10
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Lange AMC, Delsing MJMH, van Geffen M, Scholte RHJ. Alliance Between Therapist and Multi-stressed Families During the COVID-19 Pandemic: The Effect of Family-Based Videoconferencing. CHILD & YOUTH CARE FORUM 2021; 51:593-611. [PMID: 34421286 PMCID: PMC8370056 DOI: 10.1007/s10566-021-09644-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
Background A strong therapeutic alliance or working relationship is essential for effective face-to-face family-based psychotherapy. However, little is known about the use of VC on alliance in family-based therapy. The recent COVID-19 pandemic led to a national lockdown during which most family-based therapy transferred to VC. Objective The current study analyzed the development and strength of alliance prior and during lockdown for multi-stressed families participating in Multisystemic Therapy (MST). Method Alliance with the therapist was reported monthly by 846 caregivers (81% female). Using latent growth curve models (longitudinal approach), the development of alliance was estimated for families participating in MST prior to the lockdown, transferring to VC early in treatment or late in treatment. Using regression analyses (cross-sectional approach), lockdown (yes/no) was included as predictor of alliance. In these analyses, type of family (regular; intellectual disability; concerns regarding child abuse or neglect) and gender of caregiver were included as moderators. Results Both analytical approaches showed that alliance was not affected by VC, except for families with concerns of child abuse, who reported lower alliances during lockdown. However, these results where no longer significant when controlling for multiple testing. Conclusions Strong alliances can be developed and maintained during family-based VC sessions with multi-stressed families. However, for some subgroups, such as families with concerns of child abuse, VC might not be suitable or sufficient. Future research needs to investigate the potential and limitations of using VC with families.
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Affiliation(s)
- Aurelie. M. C. Lange
- Department of Psychiatry, Section of Medical Psychology & Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | | | - Marieke van Geffen
- Viersprong Institute for Studies on Personality Disorders, Halsteren, The Netherlands
| | - Ron. H. J. Scholte
- Praktikon, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Tranzo, Tilburg University, Tilburg, The Netherlands
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11
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Therapists’ Contributions to the Alliance in Home-Based Family Treatment: The Role of Alliance Building Behaviors, Personality, and Clinical Experience. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09597-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractAlliance is a robust contributor to the outcome of adult, youth, and family therapy, but little is known about therapists’ contributions to the alliance in conjoint family treatment. We investigated the predictive value of therapists’ personality, clinical experience and observed alliance building behaviors for mid-treatment alliance as reported by therapists and family members. Participants were 77 parents and 21 youth from 57 families receiving home-based family treatment from 33 therapists. Therapist openness to experience and agreeableness as well as therapists’ in-session engagement and emotional connection behaviors predicted more positive therapists’ and family members’ reports of the alliance. Therapist neuroticism, extraversion and conscientiousness predicted more negative alliance-reports. In-session safety behaviors also predicted more negative alliance-reports, but this finding was only significant for therapists’ and not family members’ reports of the alliance. Clinical experience did not predict quality of alliances. We conclude that training and supervision of family therapists could benefit from focusing on emotional connection with and active engagement of family members in treatment, and from increasing self-awareness of the impact of their personality on alliances with family members.
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12
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Gazit I, Snir S, Regev D, Bat Or M. Relationships Between the Therapeutic Alliance and Reactions to Artistic Experience With Art Materials in an Art Therapy Simulation. Front Psychol 2021; 12:560957. [PMID: 34335345 PMCID: PMC8316854 DOI: 10.3389/fpsyg.2021.560957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
In art therapy, art-making plays an important role in the therapeutic relationship. To better understand the triangular relationship between the art therapist, the client and the artwork, this study investigated the association between the therapeutic alliance and reactions to artistic experiences with art materials in an art therapy simulation. The simulation consisted of a series of 6-8 sessions in which art therapy students were divided into teams composed of a permanent observer (art therapist) and creator (client). The client's role was to self-explore through art- making, and the art therapist's role was to accompany the client. Thirty-four students, all women, who played the art therapist role, and 37 students (one male) who played the client participated in the study. Of these participants, there were 24 pairs where both participants filled out all the questionnaires. A short version of the Working Alliance Inventory (WAI) was completed by the clients and the art therapists on the second session (T1) and on the penultimate session (T2). The clients also completed the Art-Based Intervention Questionnaire (ABI) at T2. Significant positive correlations were found between indices of the WAI for the art therapist and the client and the clients' reactions to the artistic experience with art materials on the ABI. The evaluation of the emotional bond between the art therapist and the client at the start of the simulation significantly predicted the client's reactions to the artistic experience with art materials at the end of the simulation and explained 45.4% of the variance for this variable. These findings highlight factors related to the development and influence of the therapeutic alliance, as well as the role of the artistic experience in art therapy and lay the groundwork for further research.
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Affiliation(s)
- Inbal Gazit
- The School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Sharon Snir
- Department of Art Therapy, Tel Hai College, Upper Galilee, Israel
| | - Dafna Regev
- The School of Creative Arts Therapies, University of Haifa, Haifa, Israel
| | - Michal Bat Or
- The School of Creative Arts Therapies, University of Haifa, Haifa, Israel
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13
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Anderson SR, Banford Witting A, Tambling RR, Ketring SA, Johnson LN. Pressure to Attend Therapy, Dyadic Adjustment, and Adverse Childhood Experiences: Direct and Indirect Effects on the Therapeutic Alliance in Couples Therapy. JOURNAL OF MARITAL AND FAMILY THERAPY 2020; 46:366-380. [PMID: 31219191 DOI: 10.1111/jmft.12394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this study we examine the role that pressure to attend therapy, dyadic adjustment, and adverse childhood experiences (ACEs) play in developing the therapeutic alliance. A total of 351 couples received treatment as usual at three family therapy training clinics. Participants rated predictor variables at intake and alliance at the fourth session. Results of a path analysis indicate that each partner's dyadic adjustment is directly associated with the quality of her or his own alliance. In addition, when male partners report more ACEs and pressure to attend treatment, their own alliance scores decrease. Additionally, when one partner reports feeling pressure to attend therapy, the other partner's alliance decreases. Finally, for males, there is an indirect effect of dyadic adjustment on alliance through pressure to attend therapy. These results suggest that clinicians should routinely assess relationship adjustment, how pressured each partner is feeling to attend treatment, and ACEs; as these may impact alliance quality.
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14
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The application of meta-analytic (multi-level) models with multiple random effects: A systematic review. Behav Res Methods 2020; 52:2031-2052. [DOI: 10.3758/s13428-020-01373-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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15
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van der Pol TM, van Domburgh L, van Widenfelt BM, Hurlburt MS, Garland AF, Vermeiren RRJM. Common elements of evidence-based systemic treatments for adolescents with disruptive behaviour problems. Lancet Psychiatry 2019; 6:862-868. [PMID: 31255602 DOI: 10.1016/s2215-0366(19)30085-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 01/01/2023]
Abstract
A growing number of evidence-based systemic treatments for adolescents with disruptive behaviour problems exist. However, it is not clear to what extent these treatments have unique and common elements. Identification of common elements in the different treatments would be beneficial for the further understanding and development of family-based interventions, training of therapists, and research. Therefore, the aim of this Review was to identify common elements of evidence-based systemic treatments for adolescents with disruptive behaviour. Several common elements of systemic treatments were identified, showing a strong overlap between the interventions. Investigation of these common mechanisms and techniques could potentially build strong universal systemic treatment and training modules for a broad spectrum of adolescents with problem behaviours.
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Affiliation(s)
- Thimo M van der Pol
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Leiden, Netherlands; Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, Netherlands.
| | - Lieke van Domburgh
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, Amsterdam, Netherlands
| | - Brigit M van Widenfelt
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Leiden, Netherlands
| | - Michael S Hurlburt
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ann F Garland
- Department of School, Family and Mental Health Professions, University of San Diego, San Diego, CA, USA
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Leiden, Netherlands
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16
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Liu J, Peng P, Luo L. The Relation Between Family Socioeconomic Status and Academic Achievement in China: A Meta-analysis. EDUCATIONAL PSYCHOLOGY REVIEW 2019. [DOI: 10.1007/s10648-019-09494-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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