Elusive Alliance (PDF)

For some time now, the therapeutic alliance has served as a clinically significant "common factor" in positive outcomes for adult clients in most all types of psychotherapy. Yet among adolescents, the alliance has garnered interest among clinicians and researchers only relatively recently, particularly in cases of "high-risk" adolescents—teens who need mental health treatment services for a variety of disorders peculiar to this age group (e.g., anxiety disorders, depression, externalizing/disruptive behavioral disorders, etc.) but do not have access to these services or drop out of treatment prematurely. The more recent interest in the alliance with adolescents appears to be driven by myriad forces: interested researchers, frustrated clinicians, concerned parents, and policymakers engaged in healthcare reform. Elusive Alliance examines the conceptual, theoretical, and empirical bases of these myriad forces, presenting some of the highly promising work that has been accomplished over the past two decades on engaging high-risk adolescents in psychotherapy. By getting a picture of the current state of the field while also getting an in-depth analysis of a few specific programs of research supported by evidence examining adolescent engagement, researchers and clinicians alike will be able to establish a more robust knowledge base that serves to advance future treatment process research on how to engage the challenging and underserved population of high-risk adolescents. Beyond the practical appeal to researchers and clinicians, this book will be of vital interest to scholars, practitioners, and policymakers at all levels who are involved in making mental health service delivery for youth more accessible and more cost-effective.