This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Karver, M. Articles by McMakin, D. Search for Related Content Social Bookmarking                   What's this?

Relationship Processes in Youth Psychotherapy

Measuring Alliance, Alliance-Building Behaviors, and Client Involvement

University of South Florida, Tampa, mkarver{at}chuma1.cas.usf.edu

Stephen Shirk

University of Denver, CO

Jessica B. Handelsman

University of South Florida, Tampa

Sherecce Fields

University of South Florida, Tampa

Heather Crisp

Children's Hospital and Regional Medical Center, Seattle, WA

Gretchen Gudmundsen

University of Washington, Seattle

Dana McMakin

University of Denver, CO

This study explores hypothesized associations among therapist engagement strategies, therapeutic alliance, client involvement, and treatment outcome in a randomized clinical trial comparing cognitive behavioral psychotherapy and nondirective supportive psychotherapy for adolescents with depressive symptoms who have attempted suicide. Ratings from audiotapes and self-report of the first four sessions for 23 adolescent clients were used. It was expected that therapeutic relationship variables would be equally important in both treatments. However, preliminary evidence appeared to be emerging only for therapeutic alliance and client involvement being related to treatment outcome in the cognitive behavioral treatment. Therapist lapse behaviors were found to predict alliance across both treatments. On the other hand, there was some preliminary evidence for different therapist behaviors to be related to the therapeutic alliance in each treatment. Results suggest that there may be variation in effective relationship factors, depending on the specific therapeutic approach.

Key Words: therapeutic alliance • psychotherapeutic processes • involvement • therapist behaviors • adolescent psychotherapy

References

• Ackerman, S., & Hilsenroth, M. (2001). A review of therapist characteristics and techniques negatively impacting the therapeutic alliance. Psychotherapy: Theory, Research, Practice, Training, 38, 171-185.[CrossRef]
• Ackerman, S., & Hilsenroth, M. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23, 1-33.[CrossRef][Medline] [Order article via Infotrieve]
• Ackerman, S., Hilsenroth, M., & Knowles, E. (2005). Ratings of therapist dynamic activities and alliance early and late in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 42, 225-231.[CrossRef]
• Addis, M., & Jacobson, N. (2000). A closer look at the treatment rationale and homework compliance in cognitive-behavioral therapy for depression. Cognitive Therapy and Research, 24, 313-326.[CrossRef]
• Alexander, J.F., Newell, R.M., Robbins, M.S., & Turner, C.W. (1995). Observational coding in family therapy process research. Journal of Family Psychology, 9, 355-365.[CrossRef]
• Allen, J., Deering, C., Buskirk, J., & Coyne, L. (1988). Assessment of therapeutic alliances in the psychiatric hospital milieu. Journal for the Study of Interpersonal Processes, 51, 291-299.
• Bedi, R. (2006). Concept mapping the client's perspective on counseling alliance formation. Journal of Counseling Psychology, 53, 26-35.[CrossRef]
• Bickman, L., de Andrade, A.R.V., Lambert, E.W., Doucette, A., Sapyta, J., Boyd, A.S., et al. (2004). Youth therapeutic alliance in intensive treatment settings. Journal of Behavioral Health Services and Research, 31, 134-148.
• Bickman, L., Rosof-Williams, J., Salzer, M.S., Summerfelt, W.T., Noser, K., Wilson, S.J., & Karver, M.S. (2000). What information do clinicians value for monitoring adolescent client progress and outcomes? Professional Psychology, 31(1), 70-74.[CrossRef]
• Bonner, B., & Everett F. (1982). Influence of client preparation and therapist prognostic expectations on children's attitudes and expectations of psychotherapy. Journal of Clinical Child Psychology, 11, 202-208.[CrossRef]
• Bosson, J.K., & Pinel, E.C. (2006). Spilled milk? The costs of minimizing self-threats. Manuscript submitted for publication.
• Brent, D.A., & Kolko, D.J. (1991). Supportive relationship treatment manual. Pittsburg, PA: University of Pittsburgh/WPIC, Department of Psychiatry
• Brent, D.A., Roth, C., Holder, D., Kolko, D.J., Birmaher, B., Johnson, B.A., et al. (1996). Psychosocial interventions for treating adolescent depression: A comparison of three psychosocial interventions. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatment for child and adolescent disorders: Empirically based strategies for clinical practice (pp. 187-206). Washington, DC: American Psychiatric Press.
• Burr, J.A., & Nesselroade, J.R. (1990). Change measurement. In A. Von Eye (Ed.), Statistical methods in longitudinal research (Vol. 1, pp. 3-34). San Diego, CA: Academic Press.
• Busseri, M., & Tyler, J. (2003). Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form. Psychological Assessment, 15, 193-197.[CrossRef][Medline] [Order article via Infotrieve]
• Carroll, K. (2001). Constrained, confounded and confused: Why we really know so little about the therapists in treatment outcome research. Addiction, 96, 203-206.[CrossRef][Medline] [Order article via Infotrieve]
• Champion, K. (1998). The change process in therapeutic programs for children. Dissertation Abstracts International: Section B: The Sciences and Engineering, 59(5-B), 2414.
• Chu, B., & Kendall, P. (2004). Positive association of child involvement and treatment outcome within a manual-based cognitive— behavioral treatment for children with anxiety. Journal of Consulting and Clinical Psychology, 72, 821-829.[CrossRef][Medline] [Order article via Infotrieve]
• Clarkin, J.F., & Levy, K.N. (2004). Research on client variables in psychotherapy. In M. Lambert (Ed.), Handbook of psychotherapy and behavior change (5th ed.). New York: Wiley & Sons.
• Coatsworth, J.D., Santisteban, D.A., McBride, C.K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40, 313-332.[CrossRef][Medline] [Order article via Infotrieve]
• Coleman, D., & Kaplan, M. (1990). Effects of pretherapy videotape preparation on child therapy outcomes. Professional Psychology: Research and Practice, 21(3), 199-203.[Medline] [Order article via Infotrieve]
• Collins, L.M. (1996). Is reliability obsolete? A commentary on "Are simple gain scores obsolete?" Applied Psychological Measurement, 20, 289-292.[Abstract/Free Full Text]
• Colson, D.B., Cornsweet, C., Murphy, T., O'Malley, F., Hyland, P.S., McParland, M., et al. (1991). Perceived treatment difficulty and therapeutic alliance on an adolescent psychiatric hospital unit. American Journal of Orthopsychiatry, 61, 221-229.[CrossRef][Medline] [Order article via Infotrieve]
• Connolly Gibbons, M.B., Crits-Christoph, P., de la Cruz, C., Barber, J.P., Siqueland, L., & Gladis, M. (2003). Pretreatment expectations, interpersonal functioning, and symptoms in the prediction of the therapeutic alliance across supportive-expressive psychotherapy and cognitive therapy. Psychotherapy Research, 13, 59-76.[CrossRef]
• Creed, T., & Kendall, P. (2005). Therapist alliance-building behavior within a cognitive-behavioral treatment for anxiety in youth. Journal of Consulting and Clinical Psychology, 73, 498-505.[CrossRef][Medline] [Order article via Infotrieve]
• Day, L., & Reznikoff, M. (1980). Preparation of children and parents for treatment at a children's psychiatric clinic through videotaped modeling. Journal of Consulting and Clinical Psychology, 48, 303-304.[CrossRef][Medline] [Order article via Infotrieve]
• Diamond, G.M., Liddle, H.A., Hogue, A., & Dakof, G.A. (1997). Therapist alliance building techniques with adolescents in multidimensional family therapy. Paper presented at the 1998 North American Society for Psychotherapy Research, Santa Fe, NM. Manuscript submitted for publication.
• Diamond, G., Liddle, H., Hogue, A., & Dakof, G. (1999). Alliance building interventions with adolescents in family therapy: A process study. Psychotherapy: Theory, Research, Practice, Training, 36, 355-368.[CrossRef]
• Diamond, G., Siqueland, L., & Diamond, G.M. (2003). Attachment-based family therapy for depressed adolescents: Programmatic treatment development. Clinical Child and Family Psychology Review, 6, 107-127.[CrossRef][Medline] [Order article via Infotrieve]
• Donaldson, D., Spirito, A., & Esposito-Smythers, C. (2005). Treatment for adolescents following a suicide attempt: Results of a pilot trial. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 113-120.[CrossRef][Medline] [Order article via Infotrieve]
• Eltz, M., Shirk, S., & Sarlin, N. (1995). Alliance formation and treatment outcome among maltreated adolescents. Child Abuse and Neglect, 19, 419-431.[CrossRef][Medline] [Order article via Infotrieve]
• Estrada, A., & Russell, R. (1999). The development of the Child Psychotherapy Process Scales (CPPS). Psychotherapy Research, 9, 154-166.[CrossRef]
• Faw, L., Hogue, A., Johnson, S., Diamond, G.M., & Liddle, H.A. (2005). The Adolescent Therapeutic Alliance Scale: Development, initial psychometrics, and prediction of outcome in family-based substance abuse prevention counseling. Psychotherapy Research, 15(1-2), 141-154.[CrossRef]
• Fields, S., Handelsman, J.B., Karver, M.S., & Bickman, L. (2004, March). Parental and child factors that affect the therapeutic alliance. Paper presentation at the 17th annual meeting of the Florida Mental Health Institute's A System of Care for Children's Mental Health: Expanding the Research Base, Tampa, FL.
• Frank, J.D., Frank, J.B., & Cousins, N. (1993), Persuasion and healing: A comparative study of psychotherapy. Baltimore: Johns Hopkins University Press.
• Friedlander, M.L., Escudero, V., Horvath, A.O., Heatherington, L., Cabero, A., & Martens, M.P. (2006). System for observing family therapy alliances: A tool for research and practice. Journal of Counseling Psychology, 53, 214-225.[CrossRef]
• Gaston, L., Marmar, C., & Thompson, L. (1988). Relation of patient pretreatment characteristics to the therapeutic alliance in diverse psychotherapies. Journal of Consulting and Clinical Psychology, 56, 483-489.[CrossRef][Medline] [Order article via Infotrieve]
• Gorin, S. (1993). The prediction of child psychotherapy outcome: Factors specific to treatment. Psychotherapy: Theory, Research, Practice, Training, 30, 152-158.[CrossRef]
• Hagborg, W. (1991). Adolescent clients and perceived counselor characteristics: A study of background characteristics, therapeutic process, psychological distress, and social desirability. Journal of Clinical Psychology, 47, 107-113.[CrossRef][Medline] [Order article via Infotrieve]
• Harwood, M., & Eyberg, S. (2004). Therapist verbal behavior early in treatment: Relation to successful completion of parent-child interaction therapy. Journal of Clinical Child and Adolescent Psychology, 33, 601-612.[CrossRef]
• Hill, C.E. (2005). Therapist techniques, client involvement, and the therapeutic relationship: Inextricably intertwined in the therapy process. Psychotherapy, 42, 431-442.
• Hogue, A., Dauber, S., Stambaugh, L.F., Cecero, J.J., & Liddle, H.A. (2006). Early therapeutic alliance and treatment outcome in individual and family therapy for adolescent behavior problems. Journal of Consulting and Clinical Psychology, 74, 121-129.[CrossRef][Medline] [Order article via Infotrieve]
• Holmes, D.S., & Urie, R.G. (1975). Effects of preparing children for psychotherapy. Journal of Consulting and Clinical Psychology, 43, 311-318.[CrossRef][Medline] [Order article via Infotrieve]
• Holtzworth-Munroe, A., Jacobson, N., DeKlyen, M., & Whisman, M. (1989). Relationship between behavioral marital therapy outcome and process variables. Journal of Consulting and Clinical Psychology, 57, 658-662.[CrossRef][Medline] [Order article via Infotrieve]
• Horvath, A., & Bedi, R. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 37-70). New York: Oxford University Press.
• Horvath, A., & Greenberg, L. (1986). The development of the Working Alliance Inventory. In L. S. Greenberg & W. M. Pinsof (Eds.), The psychotherapeutic process: A research handbook (pp. 529-556). New York: Guilford.
• Horvath, A., & Symonds, B. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38, 139-149.[Medline] [Order article via Infotrieve]
• Hoyt, W.T. (1996). Antecedents and effects of perceived therapist credibility: A meta-analysis. Journal of Counseling Psychology, 43, 430-447.[CrossRef]
• Junod, O., de Roten, Y., Martinez, E., Drapeau, M., & Despland, J. (2005). How to address patients defences: A pilot study of the accuracy of defence interpretations and alliance. Psychology and Psychotherapy: Theory, Research, and Practice, 78, 419-430.[CrossRef]
• Karver, M., Handelsman, J., Fields, S., & Bickman, L. (2005). A theoretical model of common process factors in youth and family therapy. Mental Health Services Research, 7(1), 35-51.[CrossRef][Medline] [Order article via Infotrieve]
• Karver, M., Handelsman, J., Fields, S., & Bickman, L. (2006) Meta-analysis of therapeutic relationship variables in youth and family therapy: The evidence for different relationship variables in the child and adolescent treatment outcome literature. Clinical Psychology Review, 26, 50-65.[CrossRef][Medline] [Order article via Infotrieve]
• Karver, M., Shirk, S., Day, R., Field, S., & Handelsman, J. (2003) Rater's manual for the Alliance Observation Coding System. Unpublished manual, University of South Florida, Tampa.
• Kazantzis, N., Deane, F.P., & Ronan, K.R. (2000). Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7, 189-202.
• Keijsers, G., Schaap, C., & Hoogduin, C. (2000). The impact of the interpersonal patient and therapist behavior on outcome in cognitive-behavioral therapy: A review of empirical studies. Behavior Modification, 24(2), 264-297.[Abstract/Free Full Text]
• Kendall, P.C. (2002). Coping Cat therapist manual. Ardmore, PA: Workbook Publishing.
• Kourany, R.F., Garber, J., & Tornusciolo, G. (1990). Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 657-660.[Medline] [Order article via Infotrieve]
• Lewinsohn, P.M., Antonuccio, D.O., Steinmetz, J., & Teri, L. (1984). The coping with depression course. Eugene, OR: Castalia.
• Lynch, T.R., Chapman, A.L., Rosenthal, M.Z., Kuo, J.R., & Linehan, M.M. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of Clinical Psychology, 62, 459-480.[CrossRef][Medline] [Order article via Infotrieve]
• Markman, H.J., Leber, B.D., Cordova, A.D., & St. Peters, M. (1995). Behavioral observation and family psychology. Journal of Family Psychology, 9, 371-379.[CrossRef]
• Martin, D., Graske, J., & Davis, M. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438-450.[CrossRef][Medline] [Order article via Infotrieve]
• Martin, J., Romas, M., Medford, M., Leffert, N., & Hatcher, S.L. (2006). Adult helping qualities preferred by adolescents. Adolescence, 41(161), 127-140.[Medline] [Order article via Infotrieve]
• McKay, M.M., Stoewe, J., McCadam, K., & Gonzales, J. (1998). Increasing access to child mental health services for urban children and their caregivers. Health and Social Work, 23(1), 9-15.
• McNally, H., & Drummond, R. (1973). Clients' need for social approval and perceptions of counseling relationship and outcomes. Psychological Reports, 32, 363-366.[Medline] [Order article via Infotrieve]
• Meeks, J., & Bernet, W. (2001). The fragile alliance: An orientation to psychotherapy of the adolescent (5th ed.). Malabar, FL: Krieger.
• Merry, T., & Brodley, B.T. (2002). The nondirective attitude in client-centered therapy: A response to Kahn. Journal of Humanistic Psychology, 42(2), 66-77.[Abstract/Free Full Text]
• Mufson, L., Moreau, D., Weissman, M.M., & Klerman, G. (1993). Interpersonal psychotherapy for depressed adolescents. New York: Guilford.
• Muñoz, R.F., & Miranda, J. (1986). Group therapy manual for cognitive behavioral treatment of depression. San Francisco: University of California.
• Najavits, L., & Strupp, H. (1994). Differences in the effectiveness of psychodynamic therapists: A process outcome study. Psychotherapy: Theory, Research, Practice, Training, 31, 114-123.[CrossRef]
• Nock, M.K., & Ferriter, C. (2005). Parent management of attendance and adherence in child and adolescent therapy: A conceptual and empirical review. Clinical Child and Family Psychology Review, 8, 149-166.[CrossRef][Medline] [Order article via Infotrieve]
• Nock, M.K., & Kazdin, A.E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73, 872-879.[CrossRef][Medline] [Order article via Infotrieve]
• O'Malley, S., Suh, C., & Strupp, H. (1983). The Vanderbilt Psychotherapy Process Scale: A report on the scale development and a process-outcome study. Journal of Consulting and Clinical Psychology, 51, 581-586.[CrossRef][Medline] [Order article via Infotrieve]
• Prinz, R., & Miller, G. (1994). Family-based treatment for childhood antisocial behavior: Experimental influences on dropout and engagement. Journal of Consulting and Clinical Psychology, 62, 645—650.[CrossRef][Medline] [Order article via Infotrieve]
• Radloff, L. (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.[Abstract]
• Radloff, L. (1991). The use of the Center for Epidemiologic Studies Depression Scale in adolescent and young adults. Journal of Youth and Adolescence, 20, 149-166.[CrossRef]
• Reynolds, W.M. (1988). Suicide Ideation Questionnaire: Professional manual. Odessa, FL: Psychological Assessment Resources.
• Robbins, M.S., Liddle, H.A., Turner, C.W., Dakof, G.A., Alexander, J.F., & Kogan, S.M. (2006). Adolescent and parent therapeutic alliances as predictors of dropout in multidimensional family therapy. Journal of Family Psychology, 20, 108-116.[CrossRef][Medline] [Order article via Infotrieve]
• Robbins, M.S., Turner, C.W., Alexander, J.F., & Perez, G.A. (2003). Alliance and dropout in family therapy for adolescents with behavior problems: Individual and systemic effects. Journal of Family Psychology, 17, 534-544.[CrossRef][Medline] [Order article via Infotrieve]
• Roberts, R., Lewinsohn, P., & Seeley, J. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 58-66.[Medline] [Order article via Infotrieve]
• Rogosa, D. (1995). Myths and methods: "Myths about longitudinal research" plus supplemental questions. In J. M. Gottman (Ed.), The analysis of change (pp. 3-66). Mahwah, NJ: Erlbaum.
• Rotheram-Borus, M.J., Piacentini, J., Cantwell, C., Belin, T.R., & Song, J. (2000). The 18-month impact of an emergency room intervention for adolescent female suicide attempters. Journal of Consulting and Clinical Psychology, 68, 1081-1093.[CrossRef][Medline] [Order article via Infotrieve]
• Rotheram-Borus, M.J., Piacentini, J., Miller, S., Graae, F., Dunne, E., & Cantwell, C. (1996). Toward improving treatment adherence among adolescent suicide attempters. Clinical Child Psychology and Psychiatry, 1, 99-108.[Abstract]
• Rotheram-Borus, M.J., Piacentini, J., Van Rossem, R., Graae, F., Cantwell, C., Castro-Blanco, D., et al. (1996). Enhancing treatment adherence with a specialized emergency room program for adolescent suicide attempters. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 654-663.[CrossRef][Medline] [Order article via Infotrieve]
• Sarlin, N. (1992). Working relationships in the treatment of adolescent inpatients: Early treatment predictors and associations with outcome. Dissertation Abstracts International, 53(6-B), 3166.
• Shelef, K., Diamond, G.M., Diamond, G.S., & Liddle, H.A. (2005). Adolescent and parent alliance and treatment outcome in multidimensional family therapy. Journal of Consulting and Clinical Psychology, 73, 689-698.[CrossRef][Medline] [Order article via Infotrieve]
• Shirk, S., Gudmundsen, G.R., McMakin, D., Dent, H.C., & Karver, M. (2003). Rater's manual for the Alliance Building Behaviors Scale. Unpublished manual, University of Denver, Denver, CO.
• Shirk, S., & Karver, M. (2003). Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71, 452-464.[CrossRef][Medline] [Order article via Infotrieve]
• Shirk, S., & Karver, M.S. (2006). Process issues in cognitive-behavioral therapy for youth. In P. Kendall (Ed.), Child and adolescent therapy (3rd ed., pp. 465-491). New York: Guilford.
• Shirk, S.R., & Karver, M. (In press). Assessing the alliance in adolescent treatment: A clinical construct in search of a measure. In D. Castro-Blanco (Ed.), Treatment engagement with adolescents. Washington, DC: American Psychological Association Press.
• Shirk, S.R., & Russell, R.L. (1996). Change processes in child psychotherapy: Revitalizing treatment and research. New York: Guilford.
• Shirk, S., & Saiz, C. (1992). Clinical, empirical and developmental perspectives on the therapeutic relationship in child psychotherapy. Development and Psychopathology, 4, 713-728.
• Shuman, A.L., & Shapiro, J.P. (2002). The effects of preparing parents for child psychotherapy on accuracy of expectations and treatment attendance. Community Mental Health Journal, 38, 3-16.[CrossRef][Medline] [Order article via Infotrieve]
• Stellrecht, N.E., Joiner, T.E., & Rudd, M.D. (2006). Responding to and treating negative interpersonal processes in suicidal depression. Journal of Clinical Psychology, 62, 1129-1140.[CrossRef][Medline] [Order article via Infotrieve]
• Taft, C., Murphy, C., King, L., Musser, P., & DeDeyn, J. (2003). Posttraumatic stress disorder symptomatology among partners of men in treatment for relationship abuse. Journal of Abnormal Psychology, 114, 259-268.[CrossRef]
• Taylor, L., Adelman, H., & Kaser-Boyd, N. (1986). The Origin Climate Questionnaire as a tool for studying psychotherapeutic process. Journal of Child and Adolescent Psychotherapy, 3(1), 10-16.
• Tetzlaff, B.T., Kahn, J.H., Godley, S.H., Godley, M.D., Diamond, G.S., & Funk, R.R. (2005). Working alliance, treatment satisfaction, and patterns of posttreatment use among adolescent substance users. Psychology of Addictive Behaviors, 19, 199-207.[CrossRef][Medline] [Order article via Infotrieve]
• Tinsley, H., Bowman, S., & Ray, S. (1988). Manipulation of expectancies about counseling and psychotherapy: Review and analysis of expectancy manipulation strategies and results. Journal of Counseling Psychology, 35, 99-108.[CrossRef]
• Tracey, T.J., & Kokotovitc, A.M. (1989). Factor structure of the Working Alliance Inventory. Psychological Assessment, 1, 207-210.[CrossRef]
• Tryon, G.S., & Winograd, G. (2002). Goal consensus and collaboration. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 109-128). New York: Oxford University Press.
• Watson, J.C. (2001). Revisioning empathy. In D. J. Cain (Ed.), Humanistic psychotherapies: Handbook of research and practice (pp. 445-471). Washington, DC: American Psychological Association.
• Watson, J., & McMullen, E. (2005). An examination of therapist and client behavior in high and low alliance sessions in cognitive-behavioral therapy and process experiential therapy. Psychotherapy: Theory, Research, Practice, Training, 42, 297-310.[CrossRef]
• Weinberger, J. (2002). Short paper, large impact: Rosenweig's influence on the common factors movement. Journal of Psychotherapy Integration, 12, 67-76.[CrossRef]
• Wenning, K., & King, S. (1995). Parent orientation meetings to improve attendance and access at a child psychiatric clinic. Psychiatric Services, 46, 831-833.[Abstract/Free Full Text]
• Williams, R.H., &Zimmerman, D.W. (1996). Are simple gain scores obsolete? Applied Psychological Measurement, 20, 59-69.[Abstract]
• Wintersteen, M.B., Mensinger, J.L., & Diamond, G.S. (2005). Do gender and racial differences between patient and therapist affect therapeutic alliance and treatment retention in adolescents? Professional Psychology: Research and Practice, 36, 400-408.[CrossRef]
• Zimmerman, D.W., & Williams, R.H. (1998). Reliability of gain scores under realistic assumptions about properties of pre-test and post-test scores. British Journal of Mathematical and Statistical Psychology, 51, 343-351.

CiteULike

Connotea

Del.icio.us

Digg

Reddit

Technorati

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Karver, M. Articles by McMakin, D. Search for Related Content Social Bookmarking                   What's this?