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Simulation modeling analysis of sequential relations among therapeutic alliance, symptoms, and adherence to child-centered play therapy between a child with autism spectrum disorder and two therapists.

Authors
  • Goodman, Geoff1
  • Chung, Hyewon2
  • Fischel, Leah1
  • Athey-Lloyd, Laura1
  • 1 1 Long Island University, Brookville, New York, USA.
  • 2 2 Chungnam National University, Daejeon, South Korea. , (North Korea)
Type
Published Article
Journal
Clinical child psychology and psychiatry
Publication Date
Jul 01, 2017
Volume
22
Issue
3
Pages
455–466
Identifiers
DOI: 10.1177/1359104517691082
PMID: 28191795
Source
Medline
Keywords
License
Unknown

Abstract

This study examined the sequential relations among three pertinent variables in child psychotherapy: therapeutic alliance (TA) (including ruptures and repairs), autism symptoms, and adherence to child-centered play therapy (CCPT) process. A 2-year CCPT of a 6-year-old Caucasian boy diagnosed with autism spectrum disorder was conducted weekly with two doctoral-student therapists, working consecutively for 1 year each, in a university-based community mental-health clinic. Sessions were video-recorded and coded using the Child Psychotherapy Process Q-Set (CPQ), a measure of the TA, and an autism symptom measure. Sequential relations among these variables were examined using simulation modeling analysis (SMA). In Therapist 1's treatment, unexpectedly, autism symptoms decreased three sessions after a rupture occurred in the therapeutic dyad. In Therapist 2's treatment, adherence to CCPT process increased 2 weeks after a repair occurred in the therapeutic dyad. The TA decreased 1 week after autism symptoms increased. Finally, adherence to CCPT process decreased 1 week after autism symptoms increased. The authors concluded that (1) sequential relations differ by therapist even though the child remains constant, (2) therapeutic ruptures can have an unexpected effect on autism symptoms, and (3) changes in autism symptoms can precede as well as follow changes in process variables.

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