The Relationship Between Alliance and Client Involvement in CBT for Child Anxiety Disorders

Bryce D. McLeod, Nadia Y. Islam, Angela W. Chiu, Meghan M. Smith, Brian Chu, Jeffrey J. Wood

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Little is known about the nature of the relationship between the alliance and client involvement in child psychotherapy. To address this gap, we examined the relationship between these therapy processes over the course of cognitive-behavioral therapy (CBT) for child anxiety disorders. The sample was 31 child participants (M age = 9.58 years, SD = 2.17, range = 6–13 years, 67.7% boys; 67.7% Caucasian, 6.5% Latino, 3.2% Asian/Pacific Islander, and 22.6% mixed/other) diagnosed with a primary anxiety disorder. The participants received a manual-based individual CBT program for child anxiety or a manual-based family CBT program for child anxiety. Ratings of alliance and client involvement were collected on early (Session 2) and late (Session 8) treatment phases. Two independent coding teams rated alliance and client involvement. Change in alliance positively predicted late client involvement after controlling for initial levels of client involvement. In addition, change in client involvement positively predicted late alliance after controlling for initial levels of the alliance. The findings were robust after controlling for potentially confounding variables. In CBT for child anxiety disorders, change in the alliance appears to predict client involvement; however, client involvement also appears to predict the quality of the alliance. Our findings suggest that the nature of the relationship between alliance and client involvement may be more complex than previously hypothesized. In clinical practice, tracking alliance and level of client involvement could help optimize the impact and delivery of CBT for child anxiety.

Original languageEnglish (US)
Pages (from-to)735-741
Number of pages7
JournalJournal of Clinical Child and Adolescent Psychology
Volume43
Issue number5
DOIs
StatePublished - Sep 1 2014

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Cognitive Therapy
Anxiety Disorders
Anxiety
Confounding Factors (Epidemiology)
Hispanic Americans
Psychotherapy
Therapeutics

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Developmental and Educational Psychology

Cite this

McLeod, Bryce D. ; Islam, Nadia Y. ; Chiu, Angela W. ; Smith, Meghan M. ; Chu, Brian ; Wood, Jeffrey J. / The Relationship Between Alliance and Client Involvement in CBT for Child Anxiety Disorders. In: Journal of Clinical Child and Adolescent Psychology. 2014 ; Vol. 43, No. 5. pp. 735-741.
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The Relationship Between Alliance and Client Involvement in CBT for Child Anxiety Disorders. / McLeod, Bryce D.; Islam, Nadia Y.; Chiu, Angela W.; Smith, Meghan M.; Chu, Brian; Wood, Jeffrey J.

In: Journal of Clinical Child and Adolescent Psychology, Vol. 43, No. 5, 01.09.2014, p. 735-741.

Research output: Contribution to journalArticle

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