DEVELOPING THE THERAPEUTIC ALLIANCE IN CHILD-ADOLESCENT PSYCHOTHERAPY

The psychotherapy process research on the therapeutic alliance in chil d and adolescent psychotherapy is alarmingly scarce. Findings from the adult therapeutic alliance literature and from the few existing studi es on child and adolescent therapeutic alliance are reviewed. Bordin's (1975) model of the working alliance and Prochaska and DiClemente's ( 1988) stages of change model are employed to evaluate existing strateg ies for building alliances with child and adolescent clients and to de velop proposed strategies. The facts that (a) children are most often not self-referred and (b) frequently come to therapy in a resistant, p recontemplative stage of change are presented as the major obstacles t o forming effective alliances with children and adolescents. Tradition al child and adolescent psychotherapies may fail to develop effective alliances due to their primary focus on the development of the bond an d neglect in achieving agreement on the goals and tasks of therapy. Mu ltimodal strategies for building therapeutic alliances with children a nd adolescents incorporating techniques from emotional script theory, social problem-solving theory, motivational interviewing, and strategi c family systems theories are presented.