Lavadia, Courtney Nicole (2020-05). The Impact of Self-Reported Adolescent Strengths on Therapeutic Alliance and Psychotherapy Outcomes. Doctoral Dissertation.
Thesis
Despite the advances in strengths-based and clinical outcomes research, there have been no studies that attempt to better understand the intersection of these two bodies of literature. The current study hypothesized that self-reported adolescent strengths such as interpersonal relationships, relationships with parents, self-esteem, and self-reliance would significantly impact therapeutic alliance over the course of treatment and would moderate the association between the trend in alliance and the rate of change in therapy outcomes. Data was collected from 58 adolescents, ages 12-17. There was a total of 871 observations for the duration of treatment, ranging between 3 and 68 sessions. Hierarchical linear modeling (HLM) analyses were employed to better understand the longitudinal trends in the data. The results indicated that strengths, when controlling for age at onset and symptom type (e.g. internalizing vs externalizing symptomatology), did not significantly impact therapeutic alliance. Further, those same strengths did not moderate the overarching relationship between the trend in alliance and the rate of change in therapy outcomes. The study did indicate that therapeutic alliance increased over time, supporting the utility of patient-centered research on therapeutic processes. Recommendations for future research on strengths, therapeutic alliance, and outcomes research on clinical child therapy are discussed.
