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

Abstract

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.

Clinicians’ and Users’ Views and Experiences of a Tele-Mental Health Service Implemented Alongside the Public Mental Health System during the COVID-19 Pandemic

“…This alliance is fundamental to the success of any face-to-face psychological therapy. Previous studies have also highlighted this challenge [35,39] and have suggested that it is possible to develop this alliance [40,41], although it may have unique and yet unconfirmed characteristics [42], particularly when working with children [43]. The finding that young people, despite being comfortable using technology, did not prefer videoconferencing is perhaps due to their desire to maintain confidentiality.…”

A Relational Agent Intervention for Adolescents Seeking Mental Health Treatment: Protocol for a Randomized Controlled Trial

“…A retrospective analysis with over 35,000 adults found that users reported forming a therapeutic alliance with Woebot [20]. Therapeutic alliance, a construct familiar in psychotherapeutic treatment outcomes research, refers to the therapeutic relationship and affective bond between provider and patient and is associated with the efficacy of psychotherapy [26,27]. A randomized controlled pilot among adolescents aged 13-17 years (n=17) demonstrated W-GenZD's preliminary feasibility and utility in an outpatient primary care pediatric setting [28], but further evaluation of its feasibility and acceptability as well as clinical efficacy is warranted.…”