Category: Treatment - CBT

PS4- #A21 - Therapeutic Alliance in CBT for Routh: An Updated Meta-Analysis

Friday, Nov 17
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Therapeutic Alliance | Adolescents | CBT

Therapeutic alliance (TA) plays an important role in the successful delivery of cognitive behavioral therapy (CBT) to patients of all ages (De Nadai & Karver, 2013; Horvath, Del Re, Fluckiger, & Symonds 2011; Shirk, Karver, & Brown, 2011). For youth in particular, a robust relationship between alliance and CBT outcome has been found (Shirk & Karver, 2011). However, previous meta-analyses on TA in youth were not sufficiently powered to appropriately evaluate diversity in a variety of domains such as patient characteristics and treatment targets (e.g., anxiety, disruptive behavior). Additionally, viewpoints on the role of TA have evolved considerably in recent years (e.g., the role of TA varies substantially across treatments for different disorders; Hofmann & Barlow, 2014). Given this background, new information is needed to understand how TA functions differentially across an array of patients, clinical settings, and treatment approaches. This knowledge can facilitate an improved understanding of mechanisms of treatment outcome.


Accordingly, we will present results from an updated meta-analysis of the relationship between TA and treatment outcome in youth, with a particular focus on CBT approaches. The present research utilizes multivariate meta-analysis with robust variance estimation, which can incorporate more than five times the number of effect sizes included in prior meta-analyses. Since the time of the last meta-analysis in TA in youth, we have reviewed 6,930 additional articles for inclusion and added over 55 studies. Preliminary results of this meta-analysis indicate that TA measured at varying time points throughout treatment continues to have a robust relationship with CBT for pediatric psychopathology. Furthermore, the role of alliance appears to vary across CBT interventions for different types of psychopathology. A number of other moderators will also be discussed, including patient diversity, clinician backgrounds (e.g., years of experience, theoretical orientation), method of treatment delivery (e.g., in person, online, phone), and treatment setting (e.g., inpatient, outpatient). These findings will be discussed in the context of ongoing efforts to tailor the delivery of CBT to individual patients based on treatment matching approaches and creative evidence-based treatment delivery mechanisms such as modular treatment frameworks (Chorpita et al., 2017; Weisz et al. 2012). 

Miranda M. Courteaux

Lab Manager
University of South Florida

Maureen Monahan

Graduate Student
University of South Florida

Alessandro S. De Nadai

PhD candidate
University of South Florida, University of Mississippi Medical Center, Texas State University
Tampa, Florida

Edmund W. Orlowski

Research Assistant
University of South Florida
Tampa, Florida

Melanie A. Rosler

Project Lab Manager
University of South Florida
Tampa, Florida

Renee Hangartner

Graduate Student
University of South Florida

Lora M. Williams

Lab Manger
University of South Florida

Amanda Peterson

Graduate Student
University of South Florida

Stephen R. Shirk

Professor
University of Denver

Stephanie A. Boettcher

University of South Florida

Marc S. Karver

Associate Professor
University of South Florida
Tampa, Florida