ALLIANCE FORMATION AND TREATMENT OUTCOME AMONG MALTREATED ADOLESCENTS

This study examined relationships among maltreatment experience, thera peutic alliance formation, and treatment outcome in a sample of 38 psy chiatrically hospitalized adolescents. It was hypothesized that the ex perience of maltreatment would interfere with alliance formation, ther eby compromising the effectiveness of therapy. Results indicated that maltreatment, multiplicity of maltreatment, and type of perpetrator of maltreatment were all associated with initial alliance difficulties. None of these variables predicted change in the alliance over time; in stead, severity of interpersonal problems was the best predictor of al liance development. Maltreatment status was not directly related to tr eatment outcome; however, maltreated adolescents who failed to develop positive alliances with their therapists tended to show the poorest o utcomes. Given the strong relationship between alliance formation and outcome, clinical recommendations for therapists who treat maltreated adolescents are presented.