The Alliance-Outcome Association in CBT and Usual Care for Youth Depression Delivered in Community Settings

Abstract

THE ALLIANCE-OUTCOME ASSOCIATION IN CBT AND USUAL CARE FOR YOUTH DEPRESSION DELIVERED IN COMMUNITY SETTINGS By Shelley Beth Avny, B.S. A thesis defense submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University. Virginia Commonwealth University, 2011 Director of Thesis: Bryce D. McLeod, Ph.D. Assistant Professor Department of Psychology The child-therapist alliance is believed to be a critical ingredient of successful psychotherapy for youth depression. However, only a few studies have examined the association between the alliance and clinical outcomes in the treatment of youth depression. The present thesis examined the alliance-outcome association in two treatments for youth depression: cognitive-behavioral therapy (CBT) and usual clinical care (UC). Data were from an effectiveness trial conducted in six community clinics (see Weisz et al., 2009). Forty-one youth were randomly assigned to receive CBT or UC from community clinicians. The observed early alliance, alliance shifts, and self-reported alliance did not significantly predict childor parentreported depression outcome. However, the direction and strength of the alliance-outcome associations differed across alliance methodology (selfand observer-report) and condition (CBT and UC). Early child alliance did significantly predict treatment satisfaction. Implications and limitations of the results are discussed.