Examining change in therapeutic alliance to predict youth mental health outcomes

Kristin Duppong Hurley, Mark J. Van Ryzin, Matthew Lambert, Amy L. Stevens

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The objective of the study was to examine the link between therapeutic alliance and youth outcomes. The study was conducted at a group home with 112 youth with a disruptive-behavior diagnosis. Therapeutic alliance was collected routinely via youth and staff report. Outcome data were collected using youth and staff reports of externalizing behavior as well as behavioral incidents occurring during care. Outcome data were collected following intake into services and at 6 and 12 months of care. Data were analyzed to examine (a) whether youth behavior problems at intake were predictive of therapeutic alliance and (b) whether changes in alliance were predictive of subsequent youth outcomes. These were conducted with a 6-month service-delivery model and replicated with a 12-month model. There was some support for the first hypothesis, that initial levels of youth externalizing behavior would be related to alliance ratings; however, most of the effects were marginally significant. The second hypothesis, that changes in therapeutic alliance would be related to subsequent youth outcomes, was supported for the 6-month model, but not the 12-month model. Changes in therapeutic alliance may be predictive of youth outcomes during care. Additional research into examining therapeutic alliance trajectories is warranted to improve mental health services for youth.

Original languageEnglish (US)
Pages (from-to)90-100
Number of pages11
JournalJournal of Emotional and Behavioral Disorders
Issue number2
StatePublished - Jun 11 2015


  • adolescents
  • disruptive behavior
  • residential care
  • therapeutic alliance
  • youth outcomes

ASJC Scopus subject areas

  • Education
  • Developmental and Educational Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Examining change in therapeutic alliance to predict youth mental health outcomes'. Together they form a unique fingerprint.

Cite this