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However, most research on alliance and treatment outcome has been conducted in children and adults with internalizing problems (e.g., mood and anxiety disorders) or children with externalizing problems (e.g., conduct disorder), despite the fact that alliance may be particularly important for adults with externalizing problems such as problematic aggression, who may have high levels of resistance, blaming, and interpersonal problems. Very limited research has examined the role of alliance in individuals who present to treatment due to high levels of aggressive behaviour specifically (e.g., those convicted of a violent offence). The current systematic review examined the extant research on the relationship between alliance and outcome in treatment of highly aggressive individuals, as well as those who are diagnosed with a disorder for which aggression is a primary symptom (i.e., post\u2010traumatic stress disorder, antisocial personality disorder, and borderline personality disorder). Overall, it was shown that alliance has a positive impact on treatment outcome among those engaging in or at risk for problematic aggression. Additionally, the alliance\u2010outcome relationship may be affected by therapy modality, alliance rater perspective, and potential mechanisms of alliance. Implications for future research, including utilizing more primarily aggressive samples, are discussed.<\/jats:p>","DOI":"10.1002\/cpp.2475","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T03:00:44Z","timestamp":1589511644000},"page":"858-886","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The role of therapeutic alliance in therapy for adults with problematic aggression and associated disorders"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9683-2079","authenticated-orcid":false,"given":"Martha K.","family":"Fahlgren","sequence":"first","affiliation":[{"name":"Department of Psychology Temple University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell E.","family":"Berman","sequence":"additional","affiliation":[{"name":"Department of Psychology Mississippi State University  Starkville Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Department of Psychology Temple University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jesp.2007.07.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007558330501"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2016.04.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0026113"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0028254"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0038457"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0037024"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/107906320501700403"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-016-0069-6"},{"key":"e_1_2_8_12_1","first-page":"16","article-title":"Context of Treatment and Therapeutic Alliance: Critical Factors in Court\u2010Mandated Batterer Intervention Programs","author":"Boira S.","year":"2013","journal-title":"The Spanish Journal of Psychology"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0265407598152003"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi.2018.32.supp.115"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.10.001"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.68.2.340"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.71.5.843"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","unstructured":"Butchart A. &Mikton C.(2014).Global Status Report on Violence Prevention 2014.","DOI":"10.1136\/injuryprev-2015-041640"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2005.07.003"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.2490100104"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.72.3.411"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2009.01.012"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n1003"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(198607)42:4<562::AID-JCLP2270420404>3.0.CO;2-4"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503300802183702"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1079063214556360"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0886260517698822"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1077-7229(05)80089-6"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10503300600865393"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(99)00011-6"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6811.2000.tb00003.x"},{"key":"e_1_2_8_32_1","doi-asserted-by":"crossref","unstructured":"Fl\u00fcckiger C. 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