The relation between the therapeutic alliance and communicative intentions in therapeutic interaction during the initial phase of adolescent therapy

Abstract

This study aims to examine the connection between the therapeutic alliance (TA) – from both the patient’s and the therapist’s perspectives – and communicative intentions during the initial phase of adolescent psychotherapy. The sample comprised the first three sessions of 19 adolescents’ individual psychotherapeutic processes. Fifty therapeutic conversation segments were analyzed, representing 2043 adolescent and 3208 therapist speaking turns. The variables studied were Therapeutic Alliance, measured with the Working Alliance Inventory and Communicative Intentions (Exploring, Attuning and Resignifying), assessed by the Therapeutic Activity Coding System. A multilevel analysis was performed (HLM software). The Tasks dimension of the TA perceived by the adolescents increases the likelihood that their discourse will focus on providing and requesting information (Exploring), while also reducing the probability that they will seek to work together with the therapist to achieve mutual understanding (Attuning). The therapists’ discourse shows that a strong TA in the Bonds dimension makes it more probable for their utterances to focus on the construction of new meanings (Resignifying). Also, a stronger TA in the Goals dimension makes it more likely for their discourse to be directed toward seeking Attunement with the adolescent.