Child social and emotional functioning as predictors of therapeutic alliance in cognitive-behavior therapy for anxiety
Whitehead, Monica Renee
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This study examined baseline child social and emotional functioning as predictors of observer- and therapist-rated therapeutic alliance during a ten-week, cognitive-behavioral therapy for anxiety. It was hypothesized that better baseline functioning in both social and emotional domains would be related to stronger alliance across time. Overall, few variables were related to alliance and mixed support was found for the hypothesis. Emotion regulation was related to higher initial ratings of alliance (i.e., caregiver and teacher-reported emotion regulation for observer-rated alliance and teacher-reported emotion regulation for therapist-rated alliance). For slope of alliance, receiving prosocial behavior from peers was related to a weaker decline in observer-rated alliance whereas teacher-reported emotion regulation was related to a stronger decline in both observer- and therapist-rated alliance over time. Results suggest that only adaptive measures of emotional and social functioning may be important for understanding alliance among children with anxiety disorders and their therapists. To understand the clinical utility in predicting alliance, future research should explore different relations between social and emotional functioning, alliance, and treatment outcome.