Do caregivers’ perspectives matter? Working alliances and treatment outcomes in traumafocused cognitive behavioural therapy with children and adolescents
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
European Journal of Psychotraumatology
Abstract
Background: Caregivers play a key role in the success of trauma-focused cognitive behavioural therapy (TF-CBT). Yet, the effect of their alliance on treatment outcomes besides the
other parties in treatment has hardly been studied.
Objective: This study examined the working alliance (WA) of therapists, patients and
caregivers in TF-CBT and its contribution on treatment outcome over time.
Methods: N = 76 children and adolescents (mean age = 12.66 years, range 7–17, M/F ratio: .43)
participated in the TF-CBT arm of a randomized controlled trial. The WA was assessed with the
Working Alliance Inventory Short Version (WAI-S) at two measurement points, while symptom
level of posttraumatic stress symptoms (PTSS) was assessed with the Clinician-Administered
PTSD Scale for Children and Adolescents (CAPS-CA). Paired sample t-tests, intraclass correlations
(ICC), and mixed-effects regression models for longitudinal data were performed.
Results: The alliance rating was high across all informants, with caregivers achieving the
highest rating. The average level of cross-informant agreement on the alliance was low
between therapists and caregivers (ICC = .26) and moderate between therapists and
patients (ICC =.65). A significant contribution of an alliance improvement to the reduction
of PTSS over time was found in each of the two tested models: therapists with patients
model (b = .682) and therapists with caregivers model (b = .807). However, these effects
were not detected with all four perspectives in one comprehensive model.
Conclusion: In summary, the potential of caregivers’ views should receive more attention in
the therapeutic process of trauma-focused therapy.
Description
item.page.type
Article
item.page.format
Keywords
child abuse, caregivers, treatment, attitudes, Germany, International Resources, research
Citation
Loos, S., Tutus, D., Kilian, R., & Goldbeck, L. (2020). Do caregivers’ perspectives matter? Working alliances and treatment outcomes in trauma-focused cognitive behavioural therapy with children and adolescents. European Journal of Psychotraumatology, 11(1), 1753939.