Preserving families at risk of child abuse and neglect: the role of the helping alliance.

Family preservation services are increasingly employed to decrease the use of foster care and preserve maltreating families at high risk of child placement. First studies of family preservation services appeared to support their effectiveness in achieving these goals. However, questions are raised increasingly about their effectiveness, particularly with those families whose functioning is impaired by psychopathology and substance abuse. The time has come to seek fuller understanding of family preservation services and their differential successes. In this paper, we draw on current research in the field of psychotherapy--specifically on studies of the helping alliance and its relationship to treatment outcome--to purpose a new look at family preservation services and to inform of treatment of high-risk families.