The relationship between working alliance and therapeutic goal attainment in an adolescent inpatient, acute care behavioral hospital

A dissertation submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY in COUNSELOR EDUCATION from Texas A&M University-Corpus Christi in Corpus Christi, Texas.The working alliance continues to be the single most important aspect of counseling outcomes in various settings (Corsini and Wedding, 2011; Hanson et al., 2002; Munder et. al., 2010). Extant research is limited in examining the relationship between working alliance (Blais et al., 2010; Faw et. a., 2005) and therapeutic goal attainment (Balkin, 2013; Balkin & Roland, 2007) with adolescents in inpatient settings. The purpose of this study was to explore working alliance, measured with the Working Alliance Inventory-short (WAI-S), and therapeutic goal attainment, assessed with the Crisis Stabilization Scale (CriSS), with adolescents in an inpatient, acute-care, behavioral hospital in the South. A sample of 75 adolescents admitted into a short-term hospital for crisis reasons was utilized to examine working alliance and therapeutic goal attainment. A canonical correlation analysis was conducted to explore the extent of the relationship between these two variables. Additionally, differences between counselor and client ratings of working alliance were investigated using a repeated measures multivariate analysis of variance. The results of the canonical correlation analysis indicated that a statistically significant relationship exists between counselor ratings of working alliance and therapeutic goal attainment. Additionally, a statistically significant difference was found on the counselor and client ratings of working alliance. Lastly, no statistically significant relationship was found between client ratings of working alliance and therapeutic goal attainment. Implications and recommendations for future research are provided. A strong working alliance, specifically collaboration on tasks in counseling, is important for adolescents' achievement of goals related to stabilization. Additionally, clients may over report progress in counseling. More research is needed with adolescents in crisis inpatient settings to support further findings.Counseling & Educational PsychologyCollege of Education and Human Developmen