Observational studyBMC psychiatry2025
Treatment adherence, therapeutic alliance, and clinical outcomes during an exposure-based cognitive-behavioral therapy for pediatric irritability.
Observational study in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02531893 (Psychological Treatments for Youth With Severe Irritability), which is not on this map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Psychological Treatments for Youth With Severe Irritability
Who cites it
1 citing paper in PubMed.
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundThis study explores changes in treatment adherence and alliance during a novel parent- and child-psychotherapy for pediatric irritability. Associations between in-session therapeutic processes and symptom change were examined.
methodsForty participants (Mean age = 11.23, SD = 1.85; 37.5% female, 77.5% white) with severe irritability, and their parents, received 12 sessions of exposure-based cognitive behavioral therapy (CBT) with parent management training (PMT). Measures included clinician-rated adherence to the manual, alliance scales (Alliance Scale for Children-revised; TASC-r, and Working Alliance Inventory; WAI, respectively), and clinician-, parent- and child-reported irritability scales (Affective Reactivity Index; ARI). Linear mixed models examined session-by-session changes and associations between adherence/alliance and subsequent irritability, and vice versa.
resultsFirst, adherence to standard treatment elements decreased over time (Bs ≥ - 0.03, ps ≤ 0.010), while the focus on specific treatment components increased (i.e., exposure: B = 0.15, p = 0.001; PMT: B = 0.07, p = 0.002). Second, adherence to standard treatment elements were associated with decreased clinician-reported irritability (Bs ≥ - 2.23, p ≤ 0.042). For the alliance measures, parent-reported alliance increased over time (Bs ≥ 0.10, p ≤ 0.01); child-reported alliance did not change. Bidirectional associations were found between alliance and symptoms; specifically, child-reported alliance predicted clinician-rated irritability at next session (Bs ≥ - 0.66, p ≤ 0.053), and decreases in clinician- (Bs ≥ - 0.02, ps ≤ 0.043) and parent- (B = - 0.15, p = 0.024) reported irritability predicted increased alliance at next session.
conclusionsFindings underscore the predictive role of treatment adherence and therapeutic alliance on outcomes, in exposure-based CBT for pediatric irritability.
trial registrationClinicalTrials.gov identifier: NCT02531893; date of registration: 25/08/2015.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.