"Co-constructing" stigma and the therapist-parent alliance.

Just as many relationships are susceptible to the distorting and distancing effects of stigmatization, so are therapist-parent relationships, particularly in instances where children/youth present with significant mental illness. Therapist awareness and attunement to the dynamics of stigma are critical to the development of engaged therapist-parent alliances, and therapist-parent alliances are key to successful child/youth psychotherapy. Intersubjectivity theory offers a useful lens by which to understand stigma dynamics as mutually reinforced, "co-constructed" experiences between therapists and parents. Applying this perspective provides direction for therapists to work in ways that recognize and reduce the negative impact of stigma dynamics on this important alliance.