Therapeutic Alliance and Treatment Outcome From Three Different Perspectives in Child Trauma Therapy

The current study looked at the therapeutic alliance in child trauma therapy in a multi-site, controlled study with follow up. Parent, child, and therapist ratings were used to examine how therapeutic alliance changes over the course of Trauma Focused Cognitive Behavior Therapy (TF-CBT) that uses an exposure based method called a trauma narrative. Additionally, treatment response was examined in relation to therapeutic alliance. Participants were 65 children and their caregivers in a community based trauma therapy program in Canada. Children in treatment underwent TF-CBT, including the trauma narrative asking them to write out and process their trauma story in detail. Results for research question one indicated that despite how hard it was for children to participate in this intensive treatment method, children, therapists and parents reported positive ratings of the therapeutic alliance throughout treatment. Overall the childrens ratings of alliance became significantly more positive from therapy start to finish. Results for research question two indicated that analyses did not find any relationship between ratings of therapeutic alliance and treatment response. Results were consistent across all three raters.