Therapeutic Alliance Building During the Child Psychiatric Intake

Poster Number: NR5-34

Researchers: Keith Penska, MD, Robin Michael, PhD, StephenC. Messer, MA, PhD, Nancy B. Black, MD

Purpose:To examine “the development of therapeutic alliance during a child’s initial diagnostic interview from the parent’s perspective,” in order to “determine whether there is a difference in parental perceptions of ‘parental’ alliance when comparing [video teleconferencing (VTC)] to conventional, face to face (FTF) interviews both before and after the diagnostic session,” with the prediction “that parental alliance would be more favorable after a FTF encounter relative to a VTC intervention.”

Results: After recruiting children who needed a psychiatric intake from 2000-2003 from two semi-rural pediatric Army clinics and a major Army medical center—the former received VTC and the latter FTF—and children from the same Army medical center in 2005 for a separate cohort, parents were asked to complete questionnaires just before and after their interview. The pre-interview questionnaire asked for demographic information, thoughts toward anticipated quality of the parents’ relationship with the therapist, and perceptions of how the interview would go. The post-interview questionnaire included similar questions, and also asked about post-interview opinions. Penska said that no significant differences were seen in pre-interview questionnaire “parental alliance scores among FTF parents in both cohort I and cohort II as well as VTC parents in cohort I. In contrast, a significant difference was found between the VTC group and the FTF group on the post-[interview questionnaire], with FTF parents indicating more positive parental alliance compared to VTC parents.” Penska explained that his team used these results to conclude that “there is some intangible quality to interviewing someone FTF that helps foster therapeutic alliance.”