Child-therapist and caregiver-therapist alliance in usual care psychotherapy

常规护理心理治疗中的儿童治疗师和看护者治疗师联盟

• 批准号: 7486657
• 负责人: Erin Cecilia Accurso
• 金额: $ 2.97万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-10 至 2012-04-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7486657
• 关键词: Address; Adult; Attention; Behavior; Caregivers; Caring; Characteristics; Child; Child Care; Client; Code; Community Mental Health Services; Family; Family Caregiver; Family psychotherapy; Goals; Knowledge; Literature; Measures; Outcome; Personal Satisfaction; Problem behavior; Process; Psychotherapy; Public Health; Rate; Reporting; Research; Sampling; Therapeutic; Time; Videotape; clinically relevant; improved; programs; teacher

DESCRIPTION (provided by applicant): The broad goal of the proposed research is to examine child-therapist and caregiver-therapist alliance in families receiving community mental health services. Therapeutic alliance is an issue of paramount importance to clinicians and clients, and it is associated with outcomes in adult and child psychotherapy research. While over 2000 studies have examined the client-therapist alliance within the context of adult psychotherapy, very few studies have examined alliance within the context of child or family psychotherapy, and even fewer have investigated alliance in usual care child psychotherapy. Since little is known about the temporal stability of alliance or concordance of multiple perspectives on alliance, the proposed study will first address the complexities of measuring alliance across time and informants. Furthermore, this study will examine the association between alliance and therapeutic change in the child, caregiver, and family (i.e., whose alliance, according to whom, is most strongly associated with which outcomes). Finally, if significant alliance-outcome associations are found, therapist characteristics and behaviors associated with alliance will be explored. This last aim may generate hypotheses about therapist behaviors that could be changed to impact alliance; thus, it has significant implications for informing practice and improving care. The representative sample includes 219 children with disruptive behavior problems receiving usual care. Therapeutic alliance and various outcomes will be assessed throughout the course of psychotherapy, up to 16 months after initiating psychotherapy. In addition, coded videotapes of psychotherapy sessions will provide information about therapist behaviors that might impact therapeutic alliance strength. Coded videotapes also allow for an additional perspective (i.e., observer report) on child-therapist and caregiver/therapist alliance. PUBLIC HEALTH RELEVANCE: The proposed study examines an issue of great clinical relevance and utility within the context of usual care child psychotherapy. It addresses several methodological questions that have not been well-studied in the child psychotherapy alliance literature, and it further contributes to current knowledge about alliance outcome associations. This research has the potential to help bridge the research-practice gap because of its strong ecological validity and attention to issues of great clinical relevance and utility. Better understanding of therapeutic alliance in community mental health services is valuable because it will ultimately inform improvements in care for children.

描述（由申请人提供）：拟议研究的总体目标是检查接受社区心理健康服务的家庭中的儿童治疗师和看护者治疗师联盟。治疗联盟对于临床医生和客户来说是一个至关重要的问题，它与成人和儿童心理治疗研究的结果相关。虽然超过 2000 项研究在成人心理治疗的背景下检验了客户与治疗师的联盟，但很少有研究在儿童或家庭心理治疗的背景下检验联盟，甚至更少的研究在常规护理儿童心理治疗中调查联盟。由于对联盟的时间稳定性或联盟多种观点的一致性知之甚少，因此拟议的研究将首先解决跨时间和线人衡量联盟的复杂性。此外，本研究将探讨儿童、照顾者和家庭的联盟与治疗改变之间的关联（即，根据谁的说法，谁的联盟与哪些结果最密切相关）。最后，如果发现显着的联盟-结果关联，则将探索与联盟相关的治疗师特征和行为。最后一个目标可能会产生关于治疗师行为的假设，这些假设可能会被改变以影响联盟；因此，它对于指导实践和改善护理具有重大意义。代表性样本包括 219 名接受常规护理的有破坏性行为问题的儿童。 治疗联盟和各种结果将在整个心理治疗过程中进行评估，最长可达开始心理治疗后的 16 个月。此外，心理治疗课程的编码录像将提供有关可能影响治疗联盟强度的治疗师行为的信息。编码录像带还可以提供关于儿童治疗师和看护者/治疗师联盟的额外视角（即观察员报告）。公共卫生相关性：拟议的研究探讨了在常规护理儿童心理治疗背景下具有重大临床相关性和实用性的问题。它解决了儿童心理治疗联盟文献中尚未充分研究的几个方法论问题，并进一步促进了当前有关联盟结果关联的知识。由于其强大的生态有效性以及对具有重大临床相关性和实用性的问题的关注，这项研究有可能帮助弥合研究与实践之间的差距。更好地了解社区心理健康服务中的治疗联盟很有价值，因为它最终将有助于改善儿童护理。