This study examined the association between the therapeutic alliance and psychotherapy outcomes in 350 children and adolescents receiving outpatient therapy at a community mental health clinic. Therapeutic alliance and psychosocial distress were measured at intake 3 week, 2 month, 4 month and 6 month intervals. Participants aged 12 and older completed self report versions of the outcome and alliance measures and the parents of participants aged 4-17 completed the outcome measure. Therapists completed alliance measures for each participant. Analyses examined the relation between youth-rated therapeutic alliance and psychotherapy outcomes, premature termination, problem type, age of client, and clinician-rated alliance. Results indicated that early therapeutic alliance ratings were not related to premature termination from therapy. With the exception of the 3-week time point problem type was not found to be related to the formation of the alliance. A relationship between age of the client and the formation of a therapeutic alliance was true at the 6 month time point indicating that the therapists rated their relationships with youth under 12 years old more favorably than youth over 13 years old. Finally, the therapist's ratings of the alliance were not correlated with psychotherapy outcome. These findings indicate that associations between therapeutic alliance and psychotherapy outcomes may be less pronounced in youth treatment than in adult treatment.



College and Department

Family, Home, and Social Sciences; Psychology



Date Submitted


Document Type





therapeutic alliance, youth therapy, community mental health, outcomes

Included in

Psychology Commons