TY - JOUR
T1 - In-Session Exposure Tasks and Therapeutic Alliance Across the Treatment of Childhood Anxiety Disorders
AU - Kendall, Philip C.
AU - Comer, Jonathan S.
AU - Marker, Craig D.
AU - Creed, Torrey A.
AU - Puliafico, Anthony C.
AU - Hughes, Alicia A.
AU - Martin, Erin D.
AU - Suveg, Cynthia
AU - Hudson, Jennifer
PY - 2009/6
Y1 - 2009/6
N2 - The study examined the shape of therapeutic alliance using latent growth curve modeling and data from multiple informants (therapist, child, mother, father). Children (n = 86) with anxiety disorders were randomized to family-based cognitive-behavioral treatment (FCBT; N = 47) with exposure tasks or to family education, support, and attention (FESA; N = 39). Children in FCBT engaged in exposure tasks in Sessions 9-16, whereas FESA participants did not. Alliance growth curves of FCBT and FESA youths were compared to examine the impact of exposure tasks on the shape of the alliance (between-subjects). Within FCBT, the shape of alliance prior to exposure tasks was compared with the shape of alliance following exposure tasks (within-subjects). Therapist, child, mother, and father alliance ratings indicated significant growth in the alliance across treatment sessions. Initial alliance growth was steep and subsequently slowed over time, regardless of the use of exposure tasks. Data did not indicate a rupture in the therapeutic alliance following the introduction of in-session exposures. Results are discussed in relation to the processes, mediators, and ingredients of efficacious interventions as well as in terms of the dissemination of empirically supported treatments.
AB - The study examined the shape of therapeutic alliance using latent growth curve modeling and data from multiple informants (therapist, child, mother, father). Children (n = 86) with anxiety disorders were randomized to family-based cognitive-behavioral treatment (FCBT; N = 47) with exposure tasks or to family education, support, and attention (FESA; N = 39). Children in FCBT engaged in exposure tasks in Sessions 9-16, whereas FESA participants did not. Alliance growth curves of FCBT and FESA youths were compared to examine the impact of exposure tasks on the shape of the alliance (between-subjects). Within FCBT, the shape of alliance prior to exposure tasks was compared with the shape of alliance following exposure tasks (within-subjects). Therapist, child, mother, and father alliance ratings indicated significant growth in the alliance across treatment sessions. Initial alliance growth was steep and subsequently slowed over time, regardless of the use of exposure tasks. Data did not indicate a rupture in the therapeutic alliance following the introduction of in-session exposures. Results are discussed in relation to the processes, mediators, and ingredients of efficacious interventions as well as in terms of the dissemination of empirically supported treatments.
UR - http://www.scopus.com/inward/record.url?scp=66949140343&partnerID=8YFLogxK
U2 - 10.1037/a0013686
DO - 10.1037/a0013686
M3 - Article
C2 - 19485592
AN - SCOPUS:66949140343
SN - 0022-006X
VL - 77
SP - 517
EP - 525
JO - Journal of consulting and clinical psychology
JF - Journal of consulting and clinical psychology
IS - 3
ER -