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(p. 79) Alliance in Child and Adolescent Psychotherapy 

(p. 79) Alliance in Child and Adolescent Psychotherapy
(p. 79) Alliance in Child and Adolescent Psychotherapy

Marc S. Karver

, Alessandro S. De Nadai

, Maureen Monahan

, and Stephen R. Shirk

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date: 05 May 2021

In youth treatment, the alliance has been defined and measured as a consensual or collaborative bond. This chapter reviews varied definitions of the alliance, enumerates its frequent measures, and presents clinical examples. The authors provide a meta-analytic review on the relation between the therapeutic alliance and treatment outcome in child and adolescent psychotherapy. The meta-analysis of 43 studies revealed a weighted random effect size of r = .20, which is a small to medium effect consistent with the adult alliance literature and with prior youth meta-analyses. Multiple moderators of the alliance–outcome association were found, including diagnosis class, study design, and outcome rater. Research limitations, patient contributions, and diversity considerations follow. The chapter concludes with research-informed practices for building and maintaining the therapeutic alliance with youth.

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