Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents

Loos, Sabine; Tutus, Dunja; Kilian, Reinhold; Goldbeck, Lutz

doi:10.1080/20008198.2020.1753939

Cited by 5 publications

(11 citation statements)

References 44 publications

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“… Anderson et al (2012) randomised participants to individual CBT and internet-based CBT. Internet-based CBT ( Stjerneklar et al, 2019 ), Multimodal CBT-( Klebanoff et al, 2019 ), Trauma focused CBT- ( Zorzella et al, 2015 , 2017 ; Valadez-Sanchez, 2017 ; Kirsch et al, 2018 ; Loos et al, 2020 ), and Emotion regulation focused CBT was used by Albaum et al (2020) .…”

Section: Resultsmentioning

confidence: 99%

“…Treatment expectation effects and the effects of child-therapist collaboration and parent working alliance affected treatment outcome ( Kirsch et al, 2018 ). Post-traumatic stress symptoms reduction was associated with Therapeutic alliance ( Loos et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…The carers alliance rating was the highest in comparison to the child and therapist rating. Although concordance was low between the therapist and carer with respect to ratings, the alliance contributed to the reduction in symptom severity ( Loos et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…In one study regarding PTSD and TF-CBT, alliance ratings of therapists were lower compared to caregivers. This was attributed to subjective opinions and to the fact that therapists have a comparatively larger base to evaluate alliances in comparison to caregivers who are only rating a single therapist and have no one else to compare the therapist to Loos et al (2020) . In view of these observations, it was recommended that therapists should pay very close attention to micro-processes during therapy as they found evidence of good to moderate agreement between caregiver and therapist ( Loos et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

“…This is significant in the current times of telemedicine due to the COVID-19 crisis. With the younger generation being technology savvy, their adherence to treatment could also increase and with the constraints of time, online therapy would be great for parents and carers as evidenced in the studies ( Carpenter et al, 2018 ; Klebanoff et al, 2019 ; Loos et al, 2020 ). Although the sample size was small, these studies are contrary to the general acceptance that “the therapeutic alliance can only be established face-to-face” and is an exciting finding of this literature review which is in concordance with other opinions which state that alliance can be established without face-to-face contact ( Berger, 2017 ; Wind et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

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Therapeutic Alliance in Cognitive Behavioural Therapy in Child and Adolescent Mental Health-Current Trends and Future Challenges

Fernandes

2022

Front. Psychol.

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This extended literature review proposes to present the trends in the therapeutic alliance, outcomes, and measures in the last decade within the premises of individual cognitive behaviour therapy (CBT) and its innovations, used as an interventional measure in the context of child and adolescent mental health setting. A brief background of the rationale for conducting this literature search is presented at the start. This is followed by the methodology and design which incorporates the inclusion and exclusion criteria and the basis for the same. The critical appraisal of the primary studies is presented in the literature review section with a brief description of the summary features of the studies in the study tables followed by the results and discussion of the study findings. To summarise, the literature review of primary studies conducted in the last decade demonstrates the need for further research to be conducted both in the field of CBT in children and therapeutic alliance, competence, and therapy outcomes, integrating perspectives in child development, carer alliance, and the social construct theory in children, to allow for further innovations in CBT in the context of increasing challenges in the current times of exponentially developing technology and its utility without compromising the quality of therapy. In conclusion, recommendations are made as a guideline for future studies and research in this field.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Therapeutic Alliance in Cognitive Behavioural Therapy in Child and Adolescent Mental Health-Current Trends and Future Challenges

Fernandes

2022

Front. Psychol.

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Caregiver Satisfaction and Perceptions of Trauma-Focused Cognitive Behavioral Therapy

Brumley

Pollio

Cooper

et al. 2021

Journ Child Adol Trauma

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Although caregivers have been found to be critical to children’s healing, little has been documented about caregivers’ experiences in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). The current study describes caregivers’ satisfaction with and perceptions of TF-CBT. Caregivers (n = 431) of children/adolescents (n = 496) who completed TF-CBT filled out pre-treatment questionnaires on demographics and perceived aloneness in facing their child’s trauma, and posttreatment questionnaires on treatment satisfaction and perceptions of TF-CBT. Caregivers rated treatment satisfaction an average of 30.59 (SD = 3.15) out of a maximum score of 32 on the Client Satisfaction Questionnaire-8. The majority of caregivers endorsed that talking about their child’s trauma was more helpful than discussing other current problems, they spoke frequently with their child’s therapist about their child’s trauma, they reported information/skill building in therapy were more helpful than support received, they felt understood by their therapist, treatment helped them more effectively parent, and treatment helped improve their relationship with their child. Perceptions were associated with overall treatment satisfaction. There was a significant reduction in caregivers’ feelings of aloneness in facing their child’s trauma from pre- to posttreatment, which was also related to overall treatment satisfaction. Caregivers reported high satisfaction with TF-CBT, and identified talking about their child’s trauma as more helpful than talking about problems not related to the trauma. Caregivers endorsed benefits of participating in TF-CBT, including feeling less alone in facing their child’s trauma, improved relationship with their child, and more effective parenting skills. These results have important treatment implications.

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Mapping the progress of the process: Codevelopment of the therapeutic alliance with maltreated adolescents.

Escudero¹,

Friedlander²,

Kivlighan³

et al. 2022

Journal of Counseling Psychology

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We used a longitudinal actor–partner interdependence model to examine the codeveloping alliance in alliance empowerment therapy (AET; Escudero, 2013), a manualized team-based approach developed in Spain specifically for child welfare-involved youth. In this first evaluation of AET, we sampled 102 adolescents, 83% of whom had been removed from their homes due to abuse or neglect, and 40% of whom were in crisis at the time of referral. Before each session, clients rated their improvement-so-far; after each session, both clients and therapists completed a brief alliance measure, an adaptation of the System for Observing Family Therapy Alliances (SOFTA-s; Friedlander et al., 2006) for individual therapy. In terms of outcome, clients’ improvement ratings were significantly associated with posttreatment changes in overall functioning and personal goal attainment. With respect to the change process, growth was observed in both clients’ and therapists’ ratings of the alliance over 12 sessions, and an increased similarity in alliance ratings was due to more rapid growth in the therapists’ ratings than the clients’ ratings. Dynamic structural equation modeling indicated that at higher levels of adolescent goal attainment, a stronger association was observed between increased therapist-rated alliance and goal attainment. In other words, in the most effective cases, therapists were more responsive to how the adolescents seemed to have experienced the alliance in the previous session. The cocreated alliance perceptions were due to therapist (rather than client) responsiveness, as well as to unspecified aspects of sharing a therapy environment over time, such as familiarity with the process, regular meetings, and so on.

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Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents

Cited by 5 publications

References 44 publications

Therapeutic Alliance in Cognitive Behavioural Therapy in Child and Adolescent Mental Health-Current Trends and Future Challenges

Therapeutic Alliance in Cognitive Behavioural Therapy in Child and Adolescent Mental Health-Current Trends and Future Challenges

Caregiver Satisfaction and Perceptions of Trauma-Focused Cognitive Behavioral Therapy

Mapping the progress of the process: Codevelopment of the therapeutic alliance with maltreated adolescents.

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