Therapist Adherence to Two Treatments for Adolescent Suicide Risk
Association to Outcomes and Role of Therapeutic Alliance
Bibliographic Data
In psychotherapy research, adherence refers to the extent to which therapists deliver a treatment as intended. This study examined whether therapist adherence to two different manualized treatments was associated with improved client outcomes and whether the association was moderated by therapeutic alliance. The study sample included 320 video recordings of therapy sessions from 118 cases in a randomized controlled trial (RCT) comparing attachment‐based family therapy (ABFT) with family‐enhanced nondirective supportive therapy (FE‐NST). Recordings were selected from early, middle, and late stages of treatment. The adherence measure consisted of 24 items representing essential therapist interventions from both treatments. Trained raters coded tapes from both therapies. Adolescent self‐report of alliance was measured at session 4. Adherence to ABFT was associated with a significant increase in family cohesion at mid‐treatment but not at posttreatment. Adherence to FE‐NST was significantly associated with an increase in suicide ideation posttreatment. Using therapeutic alliance as a moderator, adherence to ABFT was significantly associated with a reduction in suicide ideation, family conflict, and higher client satisfaction posttreatment. Alliance did not positively affect the association of FE‐NST adherence to outcomes. Findings suggest that adherence to ABFT interventions may be better linked to treatment outcomes when adolescents feel a strong alliance with their therapist. Implications for future research and therapist training are explored
Alliance · Family therapy · Medical emergency · Moderation · Poison control · Psychiatry · Psychological intervention · Psychotherapist · Randomized controlled trial · Suicidal ideation · Suicide prevention · Attachment and Relationship Dynamics · Child and Adolescent Psychosocial and Emotional Development · Child Welfare and Adoption · Clinical Psychology · Medicine · Psychology · Social Psychology
Statistical analysis with missing data
Treatment fidelity in outcome studies
Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis.
Major ingredients of fidelity
The Beavers Systems Model of Family Functioning
Therapist Factors Matter
Effects of psychotherapy for depression in children and adolescents
| Unique citing works | 2 |
|---|---|
| Citations per year | 0.67 |
| Citation span | 2023 - 2026 (4) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 2 |