Therapists’ and Clients’ Perceptions of Bonding as Predictors of Outcome in Multisystemic Therapy^®

Abstract

This longitudinal study examined whether strength of and balance in self-reported caregiver, youth, and therapist emotional bonds in mid- and late treatment predicted outcomes in Multisystemic Therapy of adolescent behavior problems in a sample of 164 caregiver-youth dyads. Strength of and balance in bonds related to outcome in different ways, depending on the source of the report and time. Results showed a limited association between family members' emotional connection with the therapist and treatment outcome, whereas therapists' perceptions of bond with the caregiver showed highly significant associations across time. Caregiver-therapist agreement on emotional connection at both time points predicted therapist evaluation of treatment success and successful termination, but this was largely explained by therapists' level of alliance. Balance in bonds with the therapist between caregiver and youth had no significant associations with any outcome. The study major limitations such as examining only one component of alliance and possible implications are discussed.

Determinants and Outcomes of the Therapeutic Alliance in Treating Justice-Involved Youth: A Systematic Review of Quantitative and Qualitative Research

“…The authors queried whether restricted range in alliance scores might have contributed to the paradoxical effects, given the intervention’s highly structured, manualized nature. Furthermore, Glebova et al ( 2018 ) found that caregiver-reported bonding with the therapist at the end of treatment was associated with positive caregiver perceptions of parental monitoring post-treatment; this did not generalize across rater perspectives.…”

“…Some studies evaluated whether youth-therapist alliance quality was associated with parent-therapist alliance quality. Adolescent samples showed no significant correlations between alliance types (Hogue et al, 2006 ; Shelef et al, 2005 ) or small positive associations that increased moderately over time (Glebova et al, 2018 ; Ryan et al, 2013 ). In contrast, among younger children (6th graders), The MVPP ( 2014 ) found a strong positive relationship between initial child-therapist alliance and parent-therapist alliance.…”

“…Studies on the impact of the alliance on self- or informant-reported antisocial/delinquent and externalizing behaviors yield a complex picture of results. For example, some studies found no alliance–outcome effect (Alkalay, 2006 ; Dauber, 2004 ), positive effects for youths’ perspectives of alliance but not therapists’ (Diamond et al, 2006 ; Handwerk et al, 2008 ), or an effect for specific measures, time points, or subgroups of youth (Florsheim et al, 2000 ; Glebova et al, 2018 ; Hogue et al, 2006 ; Mattos et al, 2017 ; Shelef et al, 2005 ).…”

“…This suggested the positive effects of youth alliance were observed only when parent alliance was high or moderate, but not when low. The potential role of a strong parent-therapist alliance in reducing youth antisocial outcomes was highlighted in other work (Glebova et al, 2018 ), including a rigorous analysis that accounted for pre-treatment functioning, strength of the youth-therapist alliance, and utilized different measurement sources (Hogue et al, 2006 ).…”

Θεραπευτική Σχέση Και Μακρόχρονη Ομαδική Συστημική Ψυχοθεραπεία: Μια Ποιοτική Προσέγγιση

“…Έχουν γίνει προσπάθειες να προσδιοριστούν με μεγαλύτερη ακρίβεια συγκεκριμένες συμπεριφορές και τεχνικές που ενισχύουν τη θεραπευτική συμμαχία κατά την παρέμβαση στο οικογενειακό σύστημα (Benitez et al, 2019). Ωστόσο, τα ευρήματα για τη συσχέτιση του θεραπευτικού αποτελέσματος με την αντίληψη της οικογένειας για τη συμμαχία με τον οικογενειακό θεραπευτή δημιουργούν ερωτήματα, καθώς οι αντιλήψεις των θεραπευόμενων για τη θεραπευτική συμμαχία παρουσίασαν μικρή συσχέτιση με το θεραπευτικό αποτέλεσμα, ενώ μόνο η αντίληψη των θεραπευτών βρέθηκε να συσχετίζεται με το αποτέλεσμα της θεραπείας (Glebova et al, 2018).…”