The Role of the Therapeutic Alliance in Trauma-Focused Cognitive Behavioral Therapy with Child and Adolescent Survivors of Complex Trauma

Thumbnail Image
Issue Date
Rivkind, Michelle
Journal Title
Journal ISSN
Volume Title
This paper is an analysis of two qualitative, one mixed-methods, and seven quantitative peer-reviewed studies to gain a better understanding of the role of the therapeutic alliance in trauma-focused cognitive behavioral therapy (TF CBT) with child and adolescent survivors of complex trauma. Complex trauma refers to repetitive harmful experiences that frequently occur in the interpersonal domain, most commonly beginning during childhood and spanning over extended periods of time (Van Nieuwenhove & Meganck, 2017). TF-CBT is an approach that researchers have recommended as first-line treatment with strong empirical support that improves posttraumatic stress disorder (PTSD) in children and adolescents (Cohen & Mannarino, 2015). Although J. A. Cohen et al. (2018) have argued that the therapeutic alliance plays a central role in empowering children, adolescents, and their nonoffending caregivers (caregivers who did not perpetrate the abuse) to heal meaningfully following exposure to trauma, research on the role of the therapeutic alliance in child and adolescent trauma populations remains scarce. The results of this study indicate that the therapeutic alliance facilitates initial therapy engagement, promotes overall therapy participation and that a relationship between the therapeutic alliance and the outcome of treatment exists. These findings offer insights into the role of the three key interrelated constructs that make up the therapeutic alliance (development of an affective bond, agreement on goals, and collaboration on tasks). Therapists can utilize this information to develop therapeutic alliances that promote safety, empowerment, collaboration, and healing.
trauma-focused cognitive behavioral therapy , therapeutic alliance , trauma , childhood maltreatment , complex trauma , posttraumatic stress disorder
Attribution-NonCommercial-NoDerivs 3.0 United States , openAccess