The therapeutic alliance as experienced by children and its effect on neurological functioning

Abstract

Clinicians and researchers recognize the central role the therapeutic alliance plays in treatment outcome with adults and research with children is beginning to support similar correlations between the strength of an alliance and treatment outcome. However, unlike adult research, child process research has yet to coalesce around a definition of a child centered construct of the therapeutic alliance. The dominant exploratory qualitative section of this combined methodology thesis, seeks to develop a guiding theory of clinical interactions that enhance the development of an al1iane, as informed by children's experiences, and to better understand what children value in a therapeutic alliance. The Child Centered Alliance Development framework emerged highlighting a progressive approach to the development of an alliance moving back and forth between initiating and responsive behaviours. Also, children valued an active approach to counseling with a nice person who respected their confidentiality and helped them develop skills to solve their difficulties. Furthermore, research from the field of neuroscience has begun to demonstrate that supportive and patterned therapeutic relationships in psychotherapy produces changes in neurological functioning and morphology associated with positive outcomes in therapy. A second section of the thesis intended to explore the relationship between treatment outcome, neurological functioning, and the therapeutic alliance with children using a pre-test post-test exploratory design. Due to the resulting small sample size no inferential analysis was conducted with the data collected.