Longitudinal results of strengthening the parent-team alliance in child semi-residential psychiatry: does team investment make a difference?
Tóm tắt
In a semi-residential setting where children switch daily between treatment and home, establishment of a strong parent-team alliance can be a challenge. The development of alliance with parents and the symptoms of the child might be strengthened by a structured investment of treatment team members. Participants were caregivers and treatment team members of 46 children (6–12 years) who received semi-residential psychiatric treatment. An A–B design was applied, in which the first 22 children were assigned to the comparison group receiving treatment as usual and the next 24 to the experimental group, where treatment team members used additional alliance-building strategies. Alliance and symptom questionnaires were filled out at three-month intervals during both treatment conditions. Parent-treatment team interactions, assessed on DVD, were coded according to members’ adherence to these strategies. Multilevel analyses (using MLwiN) showed that based on reports of primary caregivers and a case manager, the alliance-building strategies had a statistically significant effect on the strength of the therapeutic alliance between treatment team members and parents. In addition, primary caregivers in the experimental group reported significant less hyperactivity symptoms of their children. Despite the methodological challenge of examining therapeutic processes in this complex treatment setting, this study supports the benefits of structured investment in the parent-team alliance.
Tài liệu tham khảo
Elvins R, Green J. The conceptualization and measurement of therapeutic alliance: an empirical review. Clin Psychol Rev. 2008;28(7):1167–87.
Lamers A, Vermeiren RR. Assessment of the therapeutic alliance of youth and parents with team members in youth residential psychiatry. Clin Child Psychol Psychiatry. 2014;20(4):640–56.
McLeod BD, Weisz JR. The therapy process observational coding system-alliance scale: measure characteristics and prediction of outcome in usual clinical practice. J Consult Clin Psychol. 2005;73(2):323–33.
Green J, Jacobs B, Beecham J, Dunn G, Kroll L, Tobias C, et al. Inpatient treatment in child and adolescent psychiatry–a prospective study of health gain and costs. J Child Psychol Psychiatry. 2007;48(12):1259–67.
Green J. The therapeutic alliance. Child Care Health Dev. 2009;35(3):298–301.
Kazdin AE, Whitley M, Marciano PL. Child–therapist and parent–therapist alliance and therapeutic change in the treatment of children referred for oppositional, aggressive, and antisocial behavior. J Child Psychol Psychiatry. 2006;47(5):436–45.
Hawley KM, Garland AF. Working alliance in adolescent outpatient therapy: youth, parent and therapist reports and associations with therapy outcomes. Child Youth Care Forum. 2008;37(2):59–74.
Kazdin AE, Whitley MK. Pretreatment social relations, therapeutic alliance, and improvements in parenting practices in parent management training. J Consult Clin Psychol. 2006;74(2):346–55.
Hawley KM, Weisz JR. Youth versus parent working alliance in usual clinical care: distinctive associations with retention, satisfaction, and treatment outcome. J Clin Child Adolesc Psychol. 2005;34(1):117–28.
Shelef K, Diamond GM, Diamond GS, Liddle HA. Adolescent and parent alliance and treatment outcome in multidimensional family therapy. J Consult Clin Psychol. 2005;73(4):689.
McLeod BD. Relation of the alliance with outcomes in youth psychotherapy: a meta-analysis. Clin Psychol Rev. 2011;31(4):603–16.
Byrne MK, Deane FP. Enhancing patient adherence: outcomes of medication alliance training on therapeutic alliance, insight, adherence, and psychopathology with mental health patients. Int J Ment Health Nurs. 2011;20(4):284–95.
Flückiger C, Del Re A, Wampold BE, Znoj H, Caspar F, Jörg U. Valuing clients’ perspective and the effects on the therapeutic alliance: a randomized controlled study of an adjunctive instruction. J Couns Psychol. 2012;59(1):18.
Creed TA, Kendall PC. Therapist alliance-building behavior within a cognitive-behavioral treatment for anxiety in youth. J Consult Clin Psychol. 2005;73(3):498.
Diamond GM, Liddle HA, Hogue A, Dakof GA. Alliance-building interventions with adolescents in family therapy: a process study. Psychother Theory Res Pract Train. 1999;36(4):355.
Karver M, Shirk S, Handelsman JB, Fields S, Crisp H, Gudmundsen G, et al. Relationship processes in youth psychotherapy: measuring alliance, alliance-building behaviors, and client involvement. J Emot Behav Disord. 2008;16(1):15–28
Jungbluth NJ, Shirk SR. Therapist strategies for building involvement in cognitive–behavioral therapy for adolescent depression. J Consult Clin Psychol. 2009;77(6):1179.
Ford CA, Davenport AF, Meier A, McRee A-L. Partnerships between parents and health care professionals to improve adolescent health. J Adolesc Health. 2011;49(1):53–7.
Brown RC, Parker KM, McLeod BD, Southam‐Gerow MA. Building a positive therapeutic relationship with the child or adolescent and parent. Evidence-based cbt for anxiety and depression in children and adolescents: a competencies-based approach. 2014:63–78.
Gross V, Goldin J. Dynamics and dilemmas in working with families in inpatient CAMH services. Clin Child Psychol Psychiatry. 2008;13(3):449–61.
Scharer K. Nurse-parent relationship building in child psychiatric units. J Child Adolesc Psychiatr Nurs. 1999;12(4):153–67.
Ainsworth F. A “no blame” approach to work with families of children and adolescents in residential care. Child Youth Care Forum. 1991;20(5):301–11.
Scharer K. Admission: a crucial point in relationship building between parents and staff in child psychiatric units. Issues Ment Health Nurs. 2000;21(8):723–44.
Kabuth B, De Tychey C, Vidailhet C. Alliance thérapeutique avec les mères et évolution clinique des enfants d’un hôpital de jour. Annales Médico-Psychologiques, Revue Psychiatrique. 2005;163:486–92.
Green J. Annotation: The therapeutic alliance—a significant but neglected variable in child mental health treatment studies. J Child Psychol Psychiatry. 2006;47(5):425–35.
Kazdin AE, Nock MK. Delineating mechanisms of change in child and adolescent therapy: methodological issues and research recommendations. J Child Psychol Psychiatry. 2003;44(8):1116–29.
Alexander LB, Dore MM. Making the parents as partners principle a reality: the role of the alliance. J Child Fam Stud. 1999;8(3):255–70.
Morrissey-Kane E, Prinz RJ. Engagement in child and adolescent treatment: the role of parental cognitions and attributions. Clin Child Fam Psychol Rev. 1999;2(3):183–98.
Holmes DS, Urie RG. Effects of preparing children for psychotherapy. J Consult Clin Psychol. 1975;43(3):311.
Ackerman SJ, Hilsenroth MJ. A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clin Psychol Rev. 2003;23(1):1–33.
Whipple JL, Lambert MJ, Vermeersch DA, Smart DW, Nielsen SL, Hawkins EJ. Improving the effects of psychotherapy: the use of early identification of treatment and problem-solving strategies in routine practice. J Couns Psychol. 2003;50(1):59.
Perepletchikova F. On the topic of treatment integrity. Clin Psychol Sci Pract. 2011;18(2):148–53.
Kroll L, Green J. The therapeutic alliance in child inpatient treatment: development and initial validation of a family engagement questionnaire. Clin Child Psychol Psychiatry. 1997;2(3):431–47.
Green JM. Engagement and empathy: a pilot study of the therapeutic alliance in outpatient child psychiatry. Child Adolesc Ment Health. 1996;1(4):130–8.
Van Widenfelt BM, Treffers PD, de Beurs E, Siebelink BM, Koudijs E. Translation and cross-cultural adaptation of assessment instruments used in psychological research with children and families. Clin Child Fam Psychol Rev. 2005;8(2):135–47.
Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45.
Hawthorne G, Elliott P. Imputing cross-sectional missing data: comparison of common techniques. Aust N Z J Psychiatry. 2005;39(7):583–90.
Rasbash J, Browne W, Goldstein H, Yang M, Plewis I, Healy M, et al. A user’s guide to MLwiN. Bristol: University of Bristol;2000.
Green J, Kroll L, Imrie D, Frances FM, Begum K, Harrison L, Anson R. Health gain and outcome predictors during inpatient and related day treatment in child and adolescent psychiatry. J Am Acad Child Adolesc Psychiatry. 2001;40(3):325–32.
Anderson T, Crowley MEJ, Himawan L, Holmberg JK, Uhlin BD. Therapist facilitative interpersonal skills and training status: a randomized clinical trial on alliance and outcome. Psychother Res. 2015: 1–19.
Zilcha-Mano S, Errázuriz P. One size does not fit all: examining heterogeneity and identifying moderators of the alliance–outcome association. J Couns Psychol. 2015;62(4):579.
De Jonge A, De Beer F, Van Oortmerssen K, Doreleijers T. Kinder- en jeugdpsychiatrische dagbehandeling. Tijdschrift voor Orthopedagogiek, Kinderpsychiatrie en Klinische Kinderpsychologie. 2003;28:63–72.
Weisz JR, Doss AJ, Hawley KM. Youth psychotherapy outcome research: a review and critique of the evidence base. Annu Rev Psychol. 2005;56:337–63.
Perepletchikova F, Treat TA, Kazdin AE. Treatment integrity in psychotherapy research: analysis of the studies and examination of the associated factors. J Consult Clin Psychol. 2007;75(6):829.