Practitioner Review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment - a systematic review and meta-analysis

Murphy, Regina; Hutton, Paul

Abstract

Background: Previous meta-analyses have only found small correlations (r=0.10 to r=0.19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study-level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta-analysis aimed to address this gap by using patient-therapist ratio as a moderator variable.

Methods: Contrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a pre-registered conceptual hierarchy. Controlling for treatment-level confounds, a random effects meta-analysis assessed the moderating effect of patient-therapist ratio on the alliance-outcome relationship in pre-defined single-predictor and multi-predictor meta-regressions.
Results: The alliance-outcome relationship was found to be larger than previously thought (k=28, N=2911, r=0.29, 95% Confidence Interval 0.21, 0.37; p

Citation

Murphy, R., & Hutton, P. (2017). Practitioner Review: Therapist variability, patient-reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment - a systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, 59(1), 5-19. https://doi.org/10.1111/jcpp.12767

• Journal Article Type: Article
• Acceptance Date: Apr 24, 2017
• Online Publication Date: Jul 6, 2017
• Publication Date: Jul 6, 2017
• Deposit Date: Apr 24, 2017
• Publicly Available Date: Jul 7, 2018
• Journal: Journal of Child Psychology and Psychiatry
• Print ISSN: 0021-9630
• Electronic ISSN: 1469-7610
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 59
• Issue: 1
• Pages: 5-19
• DOI: https://doi.org/10.1111/jcpp.12767
• Keywords: Adolescent therapy, meta-analysis, therapist variability.
• Public URL: http://researchrepository.napier.ac.uk/Output/832089
• Contract Date: Apr 24, 2017