The Role of Treatment Processes in Treatment for Children with MBID: Treatment Adherence and Observed Therapist Alliance

Abstract

The current study aimed to map treatment processes in a behavioral parent-child intervention targeting externalizing problem behavior in children with MBID. The treatment processes treatment adherence and observed therapist alliance were expected to benefit treatment outcomes for children (i.e., externalizing problem behavior) as well as for parents (i.e., parenting skills, parent-child relationship). Method: Treatment outcomes were measured by questionnaires at pre-test and post-test, and treatment processes were measured by observations. Because families (N=112) were nested under therapeutic groups (N=30), multilevel modelling was used in order to analyze the effects from treatment processes on treatment outcomes. Results: Overall, high levels of treatment adherence and observed therapist alliance were reported. The current study found marginal support for the positive effect from treatment adherence on the parent-child relationship at post-test (β = .14, p = .077). Other associations between treatment processes and treatment outcomes were not supported. No correlation was found between the two treatment processes. Conclusions: The current study partly supported previous literature on the importance of treatment adherence in psychotherapeutic interventions. Additionally, it supported previous research regarding the effects of observed therapist alliance in group interventions. Future research should therefore focus on other treatment processes such as group dynamics.