Tara Staehlin, Psy.D., is a 2016 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle.

Dr. Tara Staehlin with her Dissertation Committee, ( left to right) Dr. Alejandra Suarez, Dr. Jane Harmon Jacobs, and Dr. Douglas Kerr, at her dissertation defense, August 2016, Seattle.


outcome measures, therapeutic alliance, children, adolescents

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Background: Research has shown a link between therapeutic alliance and treatment outcome, but the definition of alliance and the focus of research has varied across studies. The present study evaluated a possible association between the alliance strength and treatment outcome, which is operationalized by participants’ outcome scores and the difference between their first and last self-reported alliance scores, in a sample of children and adolescents seeking treatment at a community mental health facility. Method: 96 children and 239 adolescents who received mental health treatment at a local community clinic were asked to complete two feasible self-reported measures during each therapeutic session, including the Child Session Rating Scale (CSRS) or the Session Rating Scale (SRS) and the Child Outcome Rating Scale (CORS) or the Outcome Rating Scale (ORS) for the current study. Results: Due to the small number of children participants in the alliance groups, it was not possible to explore the relationship between therapeutic alliance and treatment outcome. However, the adolescent participants who ended therapy with a strong therapeutic alliance had a positive treatment outcome when compared to participants who ended therapy with a poor alliance. Overall, the results were inconclusive for the children sample due to the low number of participants and data collected. The overall results for the adolescent sample did show that therapeutic alliance was a significant predictor of treatment outcome. Conclusions: From these results, we can conclude that therapeutic alliance is an important factor in mental health treatment with young clients. Conversely, the exploratory analyses also suggest that there may be other factors that influence treatment outcome. Possible explanations, such as other stakeholders involved, number of sessions attended, and models/techniques used in treatment, are examined. Implications for practice and suggestions for research are discussed. This dissertation is available in open access at AURA, and Ohio Link ETD Center,


Tara Staehlin, Psy.D., 2016.

ORCID Scholar # 0000-0002-0072-5306

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