Running head: THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 1

Therapeutic Alliance with Children and Families (Annotated Bibliography)

Name

Institution
THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 2

Abstract

For effective therapy, engaging clients is essential yet a challenging issue. Meanwhile,

when a therapist understands how to engage his or her clients effectively during therapy, clients

will eventually embrace the treatments and results will be evident within a short time.

Apparently, various studies have been conducted on the relationship developed between a

therapist and the client known as therapeutic alliance, which allows clients to view the therapy

session as an interactive process, feeling as part of the healing process. Developing therapeutic

alliance with patients in outpatient and inpatient settings has been explored by various scholars,

but the dynamics of developing therapeutic alliance with children and families in a residential

setting has been overly overlooked, prompting the need to engage in this study. The study will

explore literature regarding the establishment of therapeutic alliance with children and families

in a residential setting, challenges involved as well as best modalities to approach this kind of

therapy.

Key Words: Family based treatment, intensity of treatment, children engagement, therapeutic

alliance, and high risk young people

THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 3

Introduction

Therapeutic alliance is the bond created between a therapist and his or her clients. In the

process of psychological and emotional healing, therapeutic alliance serves as one of the most

powerful factors, sine it plays a crucial role in making the client accept his or her problem,

enabling him to embrace treatment. Various studies have established that a positive therapeutic

process correlates directly to a collaborative relationship between clients and therapists. Since

much of these studies focuses on inpatient and outpatient settings, it is imperative to conduct an

analysis of the dynamics involved in establishing a therapeutic alliance between therapists and

children with their families in a residential or home based setting.

Annotated Bibliography

Byers, A., & Lutz, D. (2015). Therapeutic Alliance With Youth in Residential Care: Challenges

and Recommendations. Residential Treatment For Children & Youth, 32(1), 1-18.

http://dx.doi.org/10.1080/0886571x.2015.1004285

Byers and Lutz in 2015 embarked on study to investigate the relationship

developed between social workers who seek to extend therapy to young people (from

school going children to young adults) in their residential areas. Most of these therapies

are conducted involving family members. The right approach determines the success in

establishing a therapeutic alliance between the therapist, family and the young people.

According to Byers and Lutz, therapeutic alliance has often been used as a measure of the

plausibility or success of a therapy session. Apparently, establishing this alliance within

and inpatient and outpatient setting is easier compared to residential based setting.

Meanwhile, there are various reasons which may make young people or else children find
THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 4

it hard establishing therapeutic alliance with social therapists in a residential setting.

These factors include but are not limited to, the young people’ s internal factors such as

temperament, family factors such as neglect and abuse, as well as community factors.

It is crucial for therapists to identify such factors in order to device an appropriate

way toy initiate the therapy session, eventually managing to create an alliance. Byers and

Lutz offers several recommendations that therapists can employ to enable them establish

an alliance with the children and parents when conducting residential therapy. First,

therapists need to treat the sessions as team approach where he or she asks the child and

family members for feedback to build a sense of togetherness. With children who might

have been undergoing traumatic periods, therapist should start of by showing empathy,

unconditional positive regard as well as congruence. Therefore, for researchers, students

and social therapists, Byers and Lutz article is a crucial source of academic information

that enlightens on the ideal approaches that should be used to establish therapeutic

alliance between young people and their families during therapy.

Duppong Hurley, K., Lambert, M., Van Ryzin, M., Sullivan, J., & Stevens, A. (2013).

Therapeutic alliance between youth and staff in residential group care: Psychometrics of

the therapeutic alliance quality scale. Children And Youth Services Review, 35(1), 56-64.

http://dx.doi.org/10.1016/j.childyouth.2012.10.009

Duppong Hurley, Lambert, Van Ryzin, Sullivan and Stevens, in 2013 conducted

research on the therapeutic alliance between young people and therapists in residential

settings where therapists also have time to interact with family members. Duppong

Hurley et al. used the case study of a married couple who are trained to extend
THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 5

psychotherapy in residential settings. What the study wanted to establish is the variations

in establishment of alliance when therapy is extended by a male therapists compared to

when it is extended by a female therapists, using a sample of 135 young people of

different gender in their residential areas. The study went on for 12 months in order to

establish credible results.

The outcome of the study were that the reactions towards therapists of a given

gender both at the residential setting and the inpatient setting is often the same, but the

struggles made by therapists to establish an alliance with a young person and the family

at the residual setting are more. Therapists should therefore, take more caution when

dealing with families and children in their residential areas if they seek to make the

therapy sessions successful. The article explains some of the struggles therapists undergo

in residential settings, claiming that advanced skills for such therapists should be

extended, in a bid to understand the settings of such homesteads. Learning about

communal influences, religious beliefs, and patriarchy issues serves as a crucial start

towards establishing the right approach for therapy to suffice. This article is therefore

insightful for the study of therapeutic alliance between families and children, since it

offers insights on what leads to failures as well as offers recommendations to avoid such

situations.

Kilpatrick, A., & Holland, T. (2011). Working with Families: An Integrative Model by Level of

Need (5th edition). Boston, Mass.: Pearson Education.

Kilpatrick & Holland in their book “Working with families” offers a unique

approach towards family therapy especially where parents and children are involved. This
THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 6

book is quite informative on the modalities and skills that a social worker such as a social

therapist should employ when dealing with parents and children in a family setting, to

ensure that therapeutic alliance suffices. The book offers a distinctive way of examining

the family’s level of needs from the basic needs to self-actualization levels to be able to

create a bond when facilitating therapy. Issues such as those of neglectful families who

require social interventions to understand the need to take care of their children are

discussed within the text. Such families may prove difficult to deal with since most of

them do not embrace therapy, but creating a working therapeutic alliance between the

social worker and the families using guidelines featured in the book promises a lot.

Furthermore, the book enlightens social therapists on the impact of a family to the

community as well as how the community influences how a certain family will bring up

its children. Ultimately, the book offers crucial insights on how to instill beneficial

ethical ideals within a family setting, using a framework that ensures therapeutic alliance

is maintained throughout the therapy period. Therefore, this book proves to be an

indispensible source of information in study, as well as for social workers and family

therapists working with families and children.

Roest, J., van der Helm, P., Strijbosch, E., van Brandenburg, M., & Stams, G. (2014). Measuring

Therapeutic Alliance With Children in Residential Treatment and Therapeutic Day

Care. Research On Social Work Practice, 26(2), 212-218.

http://dx.doi.org/10.1177/1049731514540478

Roest, van der Helm, Strijbosch, van Brandenburg and Stams in 2014 sought to

conduct a study that would enable them measure therapeutic alliance between therapists
THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 7

and children receiving residential treatment as well as therapeutic day care. Basing their

study in Netherlands, Roest et al. tried to examine how the success of a therapy can be

measured using therapeutic alliance questionnaire of children with behavioral or

psychosocial problems. These children were receiving residential therapeutic care where

a sample of 116 children was used. Apparently, since most adults seek therapy or they

understand their problems when undergoing therapy, establishing an alliance with a

therapist is often easy. On the other hand, children and youths are often sent to therapy

when the have been identified to depict a given behavioral problem, and as such they find

themselves wanting to create distance with the adults. Following this, it becomes harder

to establish an alliance with them.

The core reason why it becomes hard establishing this therapeutic alliance with

children is because they are always unaware of their problems; hence they often show

some resistance to treatment. Since Roest et al. concentrated on Children Alliance

Questionnaire as the primary measure of therapeutic alliance between children in a

residential setting with the therapists, it was established that the method can be used to

assess the quality of therapeutic alliance that therapists establishes with children and their

families when therapy is conducted in a residential setting. Therefore, using this modality

to assess alliance, this article proves instrumental for this research since it will offer

informative literature when establishing ways to measure the level of therapeutic alliance

created between a therapists and children.

Thompson, S., Bender, K., Lantry, J., & Flynn, P. (2007). Treatment Engagement: Building

Therapeutic Alliance in Home-Based Treatment with Adolescents and their

THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 8

Families. Contemporary Family Therapy, 29(1-2), 39-55.

http://dx.doi.org/10.1007/s10591-007-9030-6

In this article, Thompson, Bender, Lantry and Flynn try to establish the

importance of engaging clients during a therapy session. Thompson et al. (2007) states

that, client engagement is fundamental in ensuring that, success is realized during a

therapy session, although this is often challenging within a family set up. The hypothesis

for this study was that engaged clients often bind better with their therapists, participate

more in the therapy sessions, endorse the modalities of treatment and eventually report

higher success and satisfaction levels. The study employed a sample of 19 families where

high risk young people together with their parents were placed under home based

therapy. Since every parent as well as young person have a certain perception towards

therapy, it is often important for therapists to establish therapeutic alliance with the

clients, eventually managing to develop a shared alliance for the whole family. The study

further discusses various implications that result from effective client engagement during

therapy.

Lastly, Thompson et al. (2007) offers recommendations for therapists to seek

building therapeutic alliances with every family member in order to increase the

engagement of the clients, which eventually aids in establishing positive relationships

within the family. When therapists succeed in developing new ways in which family

members can interact, creation of therapeutic alliances becomes easy. Eventually, the

article is able to collectively and comprehensively address the modalities of establishing

positive relationships between family members, which will be a profound source for this

study since a united family offers a viable platform for establishing therapeutic alliance.
THERAPEUTIC ALLIANCE WITH CHILDREN AND FAMILIES 9

References

Byers, A., & Lutz, D. (2015). Therapeutic Alliance With Youth in Residential Care: Challenges

and Recommendations. Residential Treatment For Children & Youth, 32(1), 1-18.

http://dx.doi.org/10.1080/0886571x.2015.1004285

Duppong Hurley, K., Lambert, M., Van Ryzin, M., Sullivan, J., & Stevens, A. (2013).

Therapeutic alliance between youth and staff in residential group care: Psychometrics of

the therapeutic alliance quality scale. Children And Youth Services Review, 35(1), 56-64.

http://dx.doi.org/10.1016/j.childyouth.2012.10.009

Kilpatrick, A., & Holland, T. (2011). Working with Families: An Integrative Model by Level of

Need (5th edition). Boston, Mass.: Pearson Education.

Roest, J., van der Helm, P., Strijbosch, E., van Brandenburg, M., & Stams, G. (2014). Measuring

Therapeutic Alliance With Children in Residential Treatment and Therapeutic Day

Care. Research On Social Work Practice, 26(2), 212-218.

http://dx.doi.org/10.1177/1049731514540478

Thompson, S., Bender, K., Lantry, J., & Flynn, P. (2007). Treatment Engagement: Building

Therapeutic Alliance in Home-Based Treatment with Adolescents and their

Families. Contemporary Family Therapy, 29(1-2), 39-55.

http://dx.doi.org/10.1007/s10591-007-9030-6