Attachment history as a moderator of the alliance outcome relationship in adolescents

Sanno E. Zack, Louis Georges Castonguay, James F. Boswell, Andrew A. McAleavey, Robert Adelman, David R. Kraus, George A. Pate

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The role of the alliance in predicting treatment outcome is robust and long established. However, much less attention has been paid to mechanisms of change, including moderators, particularly for youth. This study examined the moderating role of pretreatment adolescent- caregiver attachment and its impact on the working alliance-treatment outcome relationship. One hundred adolescents and young adults with primary substance dependence disorders were treated at a residential facility, with a cognitive- behavioral emphasis. The working alliance and clinical symptoms were measured at regular intervals throughout treatment. A moderator hypothesis was tested using a path analytic approach. Findings suggested that attachment to the primary caregiver moderated the impact of the working alliance on treatment outcome, such that for youth with the poorest attachment history, working alliance had a stronger relationship with outcome. Conversely, for those with the strongest attachment histories, alliance was not a significant predictor of symptom reduction. This finding may help elucidate alliance-related mechanisms of change, lending support for theories of corrective emotional experience as one function of the working alliance in youth psychotherapy.

Original languageEnglish (US)
Pages (from-to)258-267
Number of pages10
JournalPsychotherapy
Volume52
Issue number2
DOIs
StatePublished - Jan 1 2015

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History
Caregivers
Residential Facilities
Psychotherapy
Substance-Related Disorders
Young Adult
Therapeutics

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Zack, S. E., Castonguay, L. G., Boswell, J. F., McAleavey, A. A., Adelman, R., Kraus, D. R., & Pate, G. A. (2015). Attachment history as a moderator of the alliance outcome relationship in adolescents. Psychotherapy, 52(2), 258-267. https://doi.org/10.1037/a0037727
Zack, Sanno E. ; Castonguay, Louis Georges ; Boswell, James F. ; McAleavey, Andrew A. ; Adelman, Robert ; Kraus, David R. ; Pate, George A. / Attachment history as a moderator of the alliance outcome relationship in adolescents. In: Psychotherapy. 2015 ; Vol. 52, No. 2. pp. 258-267.
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Zack, SE, Castonguay, LG, Boswell, JF, McAleavey, AA, Adelman, R, Kraus, DR & Pate, GA 2015, 'Attachment history as a moderator of the alliance outcome relationship in adolescents', Psychotherapy, vol. 52, no. 2, pp. 258-267. https://doi.org/10.1037/a0037727

Attachment history as a moderator of the alliance outcome relationship in adolescents. / Zack, Sanno E.; Castonguay, Louis Georges; Boswell, James F.; McAleavey, Andrew A.; Adelman, Robert; Kraus, David R.; Pate, George A.

In: Psychotherapy, Vol. 52, No. 2, 01.01.2015, p. 258-267.

Research output: Contribution to journalArticle

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