Alliance and Outcome Relationships in Youth Mental Health

Extant research has identified therapeutic alliance (TA) as a robust and consistent predictor of treatment retention and therapy outcomes across clinical settings, treatment modalities, and patient populations (e.g., Flückiger et al., 2019). Despite a well-developed body of evidence highlighting TA’s association with numerous treatment outcomes, there is a dearth of examinations focused solely on adolescent treatment populations (Karver et al., 2018). To add to the current literature base, this study examined the relationships between alliance and treatment outcomes with a diverse sample of adolescents receiving brief psychotherapy for clinically significant internalizing symptoms and functional impairment. A few key findings emerged. First, both youth (M = 61.34, SD = 10.26) and clinician (M = 59.04, SD = 12.00) reports on the Therapeutic Alliance Scale for Adolescents (TASA) were characteristic of a relatively positive view of alliance. Second, concordance between youth and clinician reports on the TASA was modest (r = 0.24, p r = .16, p = r = .04, p \u3c .001) were both associated with higher alliance ratings. Last, an outcome-alliance relationship was detected for only one of three outcomes. Youth with more positive perceptions of the TA generally had less severe anxiety symptoms at the culmination of treatment (β = 0.45; p \u3c .001). These patterns of significance illuminate future areas of inquiry that will improve the understanding of factors that alleviate symptoms and contribute to favorable treatment outcomes