Therapist's effect on children's therapeutic alliance: A naturalistic study

CASARI, LEANDRO; AREAS, MALENKA; ISON, MIRTA; GÓMEZ, BEATRIZ; ROUSSOS, ANDRÉS; CONSOLI, ANDRÉS; GÓMEZ PENEDO, JUAN MARTÍN

JOURNAL OF CLINICAL PSYCHOLOGY

WILEY

Año: 2023 vol. 80 p. 207 - 222

0021-9762

Objectives: The therapeutic alliance (TA) has been shownto be a predictor of psychotherapy treatment success. Inthe case of psychotherapy with children, there is a dearthof information on TA´s role. The aims of the paper are:(1) To estimate the therapist effects on children TA; (2) toinvestigate if therapists´ TA predicts children´s TA; (3) toanalyze if children´s age and sex predict children´s TA;(4) to evaluate if the therapist´s characteristics predictchildren´s TA.Methods: The sample consisted of 77 children undergoingpsychotherapy in Argentina, and the therapists (N = 29)providing services to those children. The assessment toolsutilized for the study included the Therapy Alliance Scalefor Children and the Personal Style of the TherapistQuestionnaire (PST‐Q).Results: Findings indicated that 2% of the children´sTA wasexplained by the therapists (ICC = 0.02), while 17% of thetherapists´ TA was explained by the therapists (ICC = 0.17).Therapists´ TA predicted children´s TA. Children´s age andsex did not have an effect on their own TA. Moreover,therapists with more experience achieved higher scores ofchildren´s TA. Finally, the Operative dimension of the PSThad a negative effect on children´s TA (i.e., therapists whoprefer more spontaneous interventions over structured ones may experience higher levels of therapeutic alliancewith child patients).Conclusion: We found a positive effect of the therapist´sTA on children´s TA, especially in the preference for usingmore spontaneous intervention techniques. We discuss theimplications of the findings on the training of psychotherapistswho provide services to children.