van Benthem P, Spijkerman R, Blanken P, Kleinjan M, Vermeiren R R J M, Hendriks V M
Tijdschr Psychiatr. 2021;63(7):535-542.
The quality of the therapeutic alliance is an important factor in the treatment of both adult and adolescent patients in psychiatry. Little is known about the importance of the therapeutic alliance among youths who seek help for their substance abuse problems in addiction treatment.
We investigated the importance of first treatment session therapeutic alliance for outcome in youth mental health and addiction treatment, considering both the youths' and therapists' perspective.
127 adolescents participated in a prospective clinical cohort study, with favorable or unfavorable treatment outcome after 4 months as primary outcome measure. At the end of the first treatment session, youths and their therapists were asked to rate the therapeutic alliance.
Youths' and therapists' perceptions about the therapeutic alliance at the start of treatment were predictive of treatment outcome at four months follow-up. In particular, the combined perspective on first-session alliance by both youths and therapists appeared a strong predictor for treatment outcome. If both youths and therapists rated the therapeutic alliance as weak, the percentage of youths showing a favorable treatment outcome was much lower (23%), than if youths and therapists rated the alliance as strong (70%).
The present study confirms the importance of a combined perspective on the therapeutic alliance for predicting treatment outcome among patients in youth mental health and addiction treatment.
治疗联盟的质量是精神病学中成人和青少年患者治疗的一个重要因素。对于在成瘾治疗中寻求药物滥用问题帮助的青少年而言，治疗联盟的重要性鲜为人知。
我们从青少年和治疗师双方的角度，研究了首次治疗 session 治疗联盟对青少年心理健康和成瘾治疗结果的重要性。
127 名青少年参与了一项前瞻性临床队列研究，将 4 个月后良好或不良的治疗结果作为主要结局指标。在首次治疗 session 结束时，要求青少年及其治疗师对治疗联盟进行评分。
青少年和治疗师在治疗开始时对治疗联盟的看法可预测 4 个月随访时的治疗结果。特别是，青少年和治疗师对首次 session 联盟的综合看法似乎是治疗结果的有力预测指标。如果青少年和治疗师都将治疗联盟评为薄弱，显示良好治疗结果的青少年比例（23%）远低于青少年和治疗师将联盟评为强大时的比例（70%）。
本研究证实了对治疗联盟的综合看法对于预测青少年心理健康和成瘾治疗患者的治疗结果具有重要性。
