Therapists' behaviors and youths' therapeutic alliance during trauma-focused cognitive behavioral therapy.

Objective: Trauma-focused cognitive-behavioral therapy (TF-CBT) is a recommended treatment for posttraumatic stress (PTS) in youth, and a strong therapeutic alliance predicts reductions of PTS in TF-CBT. However, little is known of how therapists can build a strong alliance. This study seeks to understand which therapist behaviors are associated with the strength of alliance in TF-CBT.

Meta-analysis of the prospective relation between alliance and outcome in child and adolescent psychotherapy.

In the youth treatment literature, the alliance has been defined and measured as a consensual or collaborative bond. In this article, we review varied definitions of the alliance, enumerate its frequent measures, and present clinical examples. We provide a meta-analytic review on the relation between the therapeutic alliance and treatment outcome in child and adolescent psychotherapy.

Therapist and client perspectives on the alliance in the treatment of traumatized adolescents.

Objective: Client ratings of the therapeutic alliance are an important predictor of outcome in the treatment of traumatized adolescents and adults, but less is known about the therapists' perspective. The aim of this study was to investigate how therapists' ratings relate to the adolescents' perspective, how individual therapist and adolescent ratings relate to change in symptoms and treatment satisfaction, and whether discrepant alliance perspectives impact treatment outcome.

Method: The sample consisted of 156 youth (mean age 15.

Testing two approaches to revictimization prevention among adolescent girls in the child welfare system.

Purpose: Girls in the child welfare system are at high risk of revictimization in adolescence. The present study compared two interventions designed to decrease revictimization in a diverse sample of adolescent child welfare-involved girls. The social learning/feminist (SL/F) intervention focused on concepts derived from social learning and feminist models of risk, such as sexism and beliefs about relationships.

Cognitive behavioral therapy for depressed adolescents exposed to interpersonal trauma: an initial effectiveness trial.

Four clinical trials have shown that a history of interpersonal trauma is associated with diminished response to cognitive-behavioral therapy (CBT) for adolescent depression. An efficacious CBT protocol for adolescent depression was modified to address cognitive deficits and distortions associated with interpersonal trauma. Initial feasibility, acceptability, and treatment impact of the modified treatment (m-CBT) were evaluated in a randomized effectiveness trial conducted in community clinics.

The therapeutic alliance in treatment of traumatized youths: relation to outcome in a randomized clinical trial.

Objective: We examined the contribution of alliance to the outcome of therapy with traumatized youths across two different treatment conditions (trauma-focused cognitive behavioral therapy [TF-CBT] and therapy as usual [TAU]).

Method: Participants were 156 youths (M age = 15.1 years, range = 10-18; 79.

Adapting Cognitive-Behavioral Therapy for Depressed Adolescents Exposed to Interpersonal Trauma: A Case Study With Two Teens.

A substantial body of evidence indicates that interpersonal trauma increases risk for adolescent and adult depression. Findings from 4 clinical trials for adolescent depression show poorer response to standard cognitive-behavioral therapy (CBT) among depressed adolescents with a trauma history than youth without such a history. This paper reports on the development of a modified CBT (mCBT) protocol that has been adapted for treating depressed adolescents who have been exposed to traumatic interpersonal events (physical/sexual abuse or witnessing domestic violence).

Promoting homework adherence in cognitive-behavioral therapy for adolescent depression.

This study used prospective, observational methods to evaluate six features of therapist behavior as predictors of homework adherence in cognitive-behavioral therapy for adolescent depression, with the goal of identifying therapist strategies with the potential to improve adolescent adherence. Therapist behaviors were expected to interact with initial levels of client resistance or adherence to predict subsequent homework completion. Participants were 50 referred adolescents (33 female, 54% ethnic minority) ages 14 to 18 (M = 15.

Positive Affect Stimulation and Sustainment (PASS) Module for Depressed Mood: A preliminary investigation of treatment-related effects.

Positive affective functioning (PAF) is critical to the development, course and treatment of depressive symptoms. Targeting key features of PAF during treatment may provide a new angle through which to improve affective functioning and reduce symptoms. The current study was a treatment development trial for the Positive Affect Stimulation and Sustainment (PASS) Module.

The alliance in child and adolescent psychotherapy.

The therapeutic alliance has a long history in the child and adolescent psychotherapy literature. This article examines prominent views on the alliance with youth and considers a number of issues that distinguish youth alliance from its adult counterpart. A meta-analysis of alliance-outcome associations in individual youth therapy is presented.

The Time Course of Positive and Negative Emotion in Dysphoria.

Prior research has demonstrated attenuated reactivity to positive stimuli among depressed and dysphoric individuals, and inconsistent evidence regarding attenuated reactivity to negative stimuli. However, such research has measured experiential reactivity to emotion stimuli in one static moment, which may obscure important information regarding the time course and dynamics of emotion. The current study employed continuous measurement of experiential emotion during and following the presentation of emotion eliciting film clips.

Therapist strategies for building involvement in cognitive-behavioral therapy for adolescent depression.

This study examined predictive relations between 9 therapist behaviors and client involvement in manual-guided, cognitive-behavioral therapy for adolescent depression. Analyses included 42 adolescents who met criteria for a depressive disorder (major depressive disorder, dysthymic disorder, or adjustment disorder with depressed mood) and who were treated in school-based clinics. Therapist behaviors hypothesized to promote client involvement were coded from Session 1 audiotapes; client involvement was coded from Session 2.

Alliance and outcome in cognitive-behavioral therapy for adolescent depression.

This study examined predictive relations between therapeutic alliance and treatment outcomes in manual-guided, cognitive-behavioral therapy for adolescent depression. Fifty-four adolescents met criteria for a depressive disorder and were treated in school-based clinics. Alliance was measured after the third session from both therapist and adolescent perspectives, and change in depressive symptoms was assessed by structured interview and self-report.

Subtypes of rumination in adolescence: associations between brooding, reflection, depressive symptoms, and coping.

Prior research has indicated that rumination contributes to the maintenance or intensification of depressive symptoms among adults. This study examined associations between rumination and depressive symptoms in early adolescence. Using a short-term longitudinal design, we evaluated relations between subtypes of rumination and both depressive symptoms and coping among a community sample of 168 adolescents (70 boys, 98 girls, age M= 13.

Links among attachment-related cognitions and adolescent depressive symptoms.

We assessed the role of self-evaluative and support-seeking processes as mediators of the relation between maternal representations and depressive symptoms in a sample of 168 young adolescents. Representations of mother as unavailable, unresponsive, and unsupportive were associated with depressive symptoms measured by semistructured interview and self-report. Moderation tests revealed that the association between maternal representations and depressive symptoms varied as a function of stress level for self-reported symptoms only.

Prediction of treatment outcome from relationship variables in child and adolescent therapy: a meta-analytic review.

Results from 23 studies examining associations between therapeutic relationship variables and treatment outcomes in child and adolescent therapy were reviewed with meta-analytic procedures. Results indicated that the overall strength of the relationship-outcome associations was modest and quite similar to results obtained with adults. This modest association was moderated by 1 substantive factor, type of patient problem, and 5 methodological factors, timing and source of relationship measurement, type and source of outcome, and shared versus cross-source measurement of relationship and outcome variables.