Swipe om te navigeren naar een ander artikel
Alliance has been shown to predict treatment outcome in family-involved treatment for youth problems in several studies. However, meta-analytic research on alliance in family-involved treatment is scarce, and to date, no meta-analytic study on the alliance–outcome association in this field has paid attention to moderating variables. We included 28 studies reporting on the alliance–outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N = 2126 families, M age youth ranging from 10.6 to 16.1). We performed three multilevel meta-analyses of the associations between three types of alliance processes and treatment outcome, and of several moderator variables. The quality of the alliance was significantly associated with treatment outcome (r = .183, p < .001). Correlations were significantly stronger when alliance scores of different measurement moments were averaged or added, when families were help-seeking rather than receiving mandated care and when studies included younger children. The correlation between alliance improvement and treatment outcome just failed to reached significance (r = .281, p = .067), and no significant correlation was found between split alliances and treatment outcome (r = .106, p = .343). However, the number of included studies reporting on alliance change scores or split alliances was small. Our findings demonstrate that alliance plays a small but significant role in the effectiveness of family-involved treatment. Future research should focus on investigating the more complex systemic aspects of alliance to gain fuller understanding of the dynamic role of alliance in working with families.
Assink, M., & Wibbelink, C. M. (2016). Fitting three-level meta-analytic models in R: A step-by-step tutorial. The Quantitative Methods for Psychology, 12, 154–174. CrossRef
*Bachler, E., Frühmann, A., Bachler, H., Aas, B., Strunk, G., & Nickel, M. (2016). Differential effects of the working alliance in family therapeutic home-based treatment of multi-problem families. Journal of Family Therapy, 38(1), 120–148. CrossRef
*Bennun, I. (1989). Perceptions of the therapist in family therapy. Journal of Family Therapy, 11, 243–255. CrossRef
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. CrossRef
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. Chichester: Wiley. CrossRef
*Chinchilla, P. (2007). Comorbidity as a moderator of process- outcome relations in individual and family therapy for adolescent substance abuse. Unpublished doctoral dissertation. Fordham University, New York.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Erlbaum.
Crits-Christoph, P., Gibbons, M. B. C., Hamilton, J., Ring-Kurtz, S., & Gallop, R. (2012). The dependability of alliance assessments: The alliance-outcome correlation is larger than you might think. Journal of Consulting Clinical Psychology, 79(3), 267–278. CrossRef
*Dauber, S. (2004). Treatment focus in individual and family therapy for adolescent substance abuse (Unpublished doctoral dissertation). Fordham University, New York.
Diamond, G. S., Wintersteen, M. B., Brown, G. K., Diamond, G. M., Gallop, R., Shelef, K., et al. (2010). Attachment-based family therapy for adolescents with suicidal ideation: A randomized controlled trial. Psychiatry, 49(2), 122–131.
Downs, S. H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomized and non-randomised studies of health care interventions. Journal of Epidemiol Community Health, 52, 377–384. CrossRef
*Escudero, V., Friedlander, M. L., Varelac, N., & Abascal, A. (2008). Observing the therapeutic alliance in family therapy: Associations with participants’ perceptions and therapeutic outcomes. Journal of Family Therapy, 30, 194–214. CrossRef
*Flicker, S. M., Turner, C. W., Waldron, H. B., Brody, J. L., & Ozechowski, T. J. (2008). Ethnic background, therapeutic alliance, and treatment retention in functional family therapy with adolescents who abuse substances. Journal of Family Psychology, 22, 167–170. https://doi.org/10.1037/0893-3188.8.131.52. CrossRefPubMed
*Forsberg, S. (2011). The relationship between therapeutic alliance and treatment outcome in a comparative study of individual and family therapy for adolescent anorexia nervosa (Unpublished doctoral dissertation). Palo Alto: Palo Alto University.
Friedlander, M. L., Escudero, V., & Heatherington, L. (2006). Therapeutic alliances in couple and family therapy. An empirically informed guide to practice. Washington DC: American Psychological Association. CrossRef
*Friedlander, M. L., Lambert, J. E., & Muñiz de la Peña, C. (2008). A step toward disentangling the alliance/improvement cycle in family therapy. Journal of Counseling Psychology, 55, 118–124. CrossRef
Ginsburg, G. S., & Schlossberg, M. C. (2002). Family-based treatment of childhood anxiety disorders. International Review of Psychiatry, 14(2), 143–154. CrossRef
*Glueckauf, R. L., Liss, H. J., McQuillen, D. E., Webb, P. M., Dairaghi, J., & Carter, C. B. (2002). Therapeutic alliance in family therapy for adolescents with epilepsy: An exploratory study. The American Journal of Family Therapy, 30, 125–139. CrossRef
Henderson, C. E., Dakof, G. A., Greenbaum, P. E., & Liddle, H. A. (2010). Effectiveness of multidimensional family therapy with higher severity substance-abusing adolescents: Report from two randomized controlled trials. Journal of Consulting and Clinical Psychology, 78(6), 885–897. CrossRefPubMedPubMedCentral
Higgins, J. P., Altman, D. G., Gotzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., et al. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomized trials. British Medical Journal. https://doi.org/10.1136/bmj.d5928.
Horvath, A. O. (2006). The alliance in context: Accomplishments, challenges and future directions. Psychotherapy: Theory, Research, Practice, Training, 43, 258–263. CrossRef
Horvath, A. O., & Bedi, R. P. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 37–69). New York: Oxford University Press.
Hunter, J. E., & Schmidt, F. L. (1990). Methods of meta-analysis: Correcting error and bias in research findings. Newbury Park: Sage.
*Johnson, L. N., Ketring, S. A., Rohacs, J., & Brewer, A. L. (2006). Attachment and the therapeutic alliance in family therapy. The American Journal of Family Therapy, 34, 205–218. CrossRef
Karver, M. S., & Carporino, N. (2010). The use of empirically supported strategies for building a therapeutic relationship with an adolescent with ODD. Cognitive and Behavioral Practice, 17, 222–232. CrossRef
Karver, M. S., Handelsman, J. B., Fields, S., & Bickman, L. (2006). Meta-analysis of therapeutic relationship variables in youth and family therapy: The evidence for different relationship variables in the child and adolescent treatment outcome literature. Clinical Psychology Review, 26, 50–65. CrossRefPubMed
*Kim, H. (2007). Client growth and alliance development in solution- focused brief family therapy. Unpublished doctoral dissertation. State University of New York at Buffalo.
Kindsvatter, A., & Lara, T. M. (2012). The facilitation and maintenance of the therapeutic alliance in family therapy. Contemporary Psychotherapy, 42, 235–242. CrossRef
*Lange, A. M. C., Van der Rijken, R. E. A., Delsing, M. J. M. H., Busschbach, J. J. V., Van Horn, J. E. & Scholte, R. H. J. (in preparation). Does growth in alliance and therapist adherence predict treatment outcomes in a systemic therapy?
Latimer, J. (2001). A meta-analytic examination of youth delinquency, family treatment, and recidivism. Canadian Journal of Criminology, 43, 237–253.
Liddle, H. A. (2002). Multidimensional family therapy for adolescent cannabis users. Cannabis youth treatment series (Vol. 5). Rockville: U.S. Department of Health and Human Services. Retrieved from http://www.mdft.org/mdft/media/files/Publications/MDFT-(2002)-CYT_Manual.pdf.
Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLOS Medicine, 6(7), 1–6. CrossRef
Pinsof, W. B. (1994). An integrative systems perspective on the therapeutic alliance: Theoretical, clinical, and research implications. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory, research and practice (pp. 173–195). New York: Wiley.
Pinsof, W. B., & Catherall, D. (1986). The integrative psychotherapy alliance: Family, couple and individual therapy scales. Journal of Marital and Family Therapy, 12, 137–151. CrossRef
Pinsof, W. B., Zinbarg, R., & Knobloch-Fedders, L. M. (2008). Factorial and construct validity of the revised short form Integrative Psychotherapy Alliance Scales for family, couple, and individual therapy. Psychotherapy Research, 7, 281–301.
R Core Team. (2016). R: The R project for statistical computing. Vienna, Austria: The R Foundation for Statistical Computing. Retrieved from www.r-project.org.
Rait, D. S. (2000). The therapeutic alliance in couples and family therapy. Psychotherapy in Practice, 56(2), 211–224.
Rigter, H., Henderson, C. E., Pelc, I., Tossmann, P., Phan, O., Hendriks, V., et al. (2013). Multidimensional Family Therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings. Drug and Alcohol Dependence, 130(1–3), 85–93. CrossRefPubMed
Rosenthal, R. (1991). Meta-analytic procedures for social research (Vol. 86). Newbury Park: Sage. CrossRef
Rosenthal, R. (1994). Parametric measures of effect size. In H. Cooper & L. V. Hedges (Eds.), The handbook of research synthesis (pp. 231–244). New York: Sage.
Rosenthal, R. (1995). Writing meta-analytic reviews. Psychological Bulletin, 118(2), 183–192. CrossRef
Sexton, T. L., & Alexander, J. F. (2004). Functional family therapy clinical training manual. Retrieved from http://www.functionalfamilytherapy.com/wp-content/uploads/FFT-Clinical-Manual-Blue-Blook-8.1.08.pdf.
Sexton, T., & Turner, C. W. (2011). The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. Couple and Family Psychology: Research and Practice, 1(S), 3–15. CrossRef
Sotero, L., Cunha, D., Da Silva, J. T., Escudero, V., & Relvas, A. P. (in press). Building alliances with (in)voluntary clients: A study focused on therapists’ observable behaviors. Manuscript accepted for publication by Family Process.
Sotero, L., Major, S., Escudero, V., & Relvas, A. P. (2016). The therapeutic alliance with involuntary clients: How does it work? Journal of Family Therapy, 38(1), 36–58. CrossRef
Storch, E. A., Geffken, G. R., Merlo, L. J., Mann, G., Danny Duke, M. P. H., Munson, M., et al. (2007). Family-based cognitive-behavioral therapy for pediatric obsessive–compulsive disorder: Comparison of intensive and weekly approaches. Journal of the American Academy of Child and Adolescent Psychiatry, 46(4), 469–478. CrossRefPubMed
Tabachnick, B. G., & Fidell, L. S. (2012). Using multivariate statistics (6th ed.). Boston: Pearson Education.
Van den Noortgate, W., & Onghena, P. (2003). Multi-level meta-analysis: A comparison with traditional meta-analytical procedures. Educational and Psychological Measurement, 63(5), 765–790. CrossRef
Viechtbauer, W. (2015). Meta-analysis package for R. Retrieved from http://cran.rproject.org/web/packages/metafor/metafor.pdf.
- Alliance and Treatment Outcome in Family-Involved Treatment for Youth Problems: A Three-Level Meta-analysis
M. J. Welmers-van de Poll
J. J. Roest
T. van der Stouwe
A. L. van den Akker
G. J. J. M. Stams
G. J. Overbeek
J. J. W. de Swart
- Springer US