Alliance and Treatment Outcome in Family-Involved Treatment for Youth Problems: A Three-Level Meta-analysis.

Alliance has been shown to predict treatment outcome in family-involved treatment for youth problems in several studies. However, meta-analytic research on alliance in family-involved treatment is scarce, and to date, no meta-analytic study on the alliance-outcome association in this field has paid attention to moderating variables. We included 28 studies reporting on the alliance-outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N = 2126 families, M age youth ranging from 10.6 to 16.1). We performed three multilevel meta-analyses of the associations between three types of alliance processes and treatment outcome, and of several moderator variables. The quality of the alliance was significantly associated with treatment outcome (r = .183, p < .001). Correlations were significantly stronger when alliance scores of different measurement moments were averaged or added, when families were help-seeking rather than receiving mandated care and when studies included younger children. The correlation between alliance improvement and treatment outcome just failed to reached significance (r = .281, p = .067), and no significant correlation was found between split alliances and treatment outcome (r = .106, p = .343). However, the number of included studies reporting on alliance change scores or split alliances was small. Our findings demonstrate that alliance plays a small but significant role in the effectiveness of family-involved treatment. Future research should focus on investigating the more complex systemic aspects of alliance to gain fuller understanding of the dynamic role of alliance in working with families.

Parents and partners in crime: a six-year longitudinal study on changes in supportive relationships and delinquency in adolescence and young adulthood.

BACKGROUND: This study sought the answer to three questions: 1. Is having an intimate partner associated with the level of delinquency? 2. Does the quality of the relationship with an intimate partner, operationalised as partner support, predict the level of delinquency? 3. Does a relationship with an intimate partner or age moderate the association between parental support and delinquency? METHOD: Data from a three-wave, six-year longitudinal study of 1302 adolescents and young adults, aged 12-23 at wave 1, were used. RESULTS: 1. Univariate latent growth curve analysis showed that, as predicted, having an intimate partner does not lead to less criminality among young adults over the age of 20. We found no support for the hypothesis among the group of 12- to 20-year-old adolescents, since the group of mid-adolescents who consistently have a partner is more criminal than the other groups. 2. Our findings show that partner support is negatively related to criminality in both 12- to 20-year-olds and 21- to 23-year-olds. The longitudinal effect of partner support is also uni-directional: partner support T1 certainly has an impact on criminality T3, but the reverse is not true. In both groups the influence of partner support is also greater than that of parental support. 3. Having an intimate partner moderates the association between parental support and delinquency, but in an age-specific manner. Parental support has no bearing on criminality when adolescents and young adults continuously have an intimate partner. Parental support does, however, cause a reduction in the level of criminality in adolescents and young adults who have never had a partner and adolescents who only have a partner at time 3. CONCLUSIONS: We interpret our results in terms of shifts in the relational system: if an adolescent finds a partner, that partner takes over the role of the parents in reducing criminality; if not, the parents remain important in doing so.