{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T21:16:14Z","timestamp":1788038174672,"version":"build-2784847793"},"reference-count":88,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clin Psychol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Mindfulness is increasingly being implemented in child and adolescent therapy. However, little is known about its effectiveness in individual settings within a clinical outpatient context. We investigated the effects of session\u2010introducing mindfulness interventions (IG\u2010M) compared to session\u2010introducing relaxation interventions (CG\u2010R) and no standardized session\u2010introduction (CG) on symptomatic outcome and therapeutic alliance in cognitive\u2010behavioral therapy using a randomized controlled design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>One thousand four hundred and seventy\u2010eight of 90 outpatient adolescents (11\u201319 years) diagnosed with depression, an anxiety disorder, or a hyperkinetic disorder were assessed. Symptomatic outcome was assessed by the German version of the Youth Self\u2010Report 11\u201018R at five measurement time points (pre, 3rd, 10th, 17th therapy session, post), therapeutic alliance was assessed by the German version of the Therapeutic Alliance Scales for Children after every therapy session (1st\u201324th therapy session). Statistical analyses were conducted using multilevel modeling. The RCT was registered at ClinicalTrials.gov (NCT04034576).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multilevel modeling revealed a significant decrease of symptomatic outcome in IG\u2010M compared to CG, but not compared to CG\u2010R, over time. A significant increase in therapeutic alliance over time was observed from the therapists' perspective with no group differences. Therapeutic alliance from patients' perspective significantly increased in IG\u2010M and significantly decreased in CG. There was no statistically meaningful change in therapeutic alliance from the patients' perspective in CG\u2010R.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IG\u2010M had positive effects on symptomatic outcome and therapeutic alliance compared to CG, but did not outperform CG\u2010R. Future studies that control confounding variables are highly relevant to understand the role of mindfulness in individual youth psychotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jclp.70216","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T20:40:42Z","timestamp":1788036042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Mindfulness as a Session\u2010Introduction on Symptoms and Alliance in Individual Cognitive\u2010Behavioral Therapy With Children and Adolescents: A Randomized Controlled Trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3952-9070","authenticated-orcid":false,"given":"Julia","family":"Kalmar","sequence":"first","affiliation":[{"name":"Center for Psychological Psychotherapy, Institute of Psychology Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8683-293X","authenticated-orcid":false,"given":"Ines","family":"Baumann","sequence":"additional","affiliation":[{"name":"Center for Psychological Psychotherapy, Institute of Psychology Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"},{"name":"Department of Developmental Psychology Institute of Psychology, Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Schleiting","sequence":"additional","affiliation":[{"name":"Center for Psychological Psychotherapy, Institute of Psychology Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3272-1630","authenticated-orcid":false,"given":"Anne","family":"Gr\u00fcnert","sequence":"additional","affiliation":[{"name":"Department of Developmental Psychology and Research Methods, Institute of Psychology RWTH Aachen\u2010University Aachen Germany"},{"name":"Department of Education and Human Development Leibniz Institute for Research and Information in Education (DIPF) Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Vonderlin","sequence":"additional","affiliation":[{"name":"Center for Psychological Psychotherapy, Institute of Psychology Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7415-9856","authenticated-orcid":false,"given":"Katajun","family":"Lindenberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology of Childhood and Adolescence, Institute of Psychology Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0515-1126","authenticated-orcid":false,"given":"Andreas B.","family":"Neubauer","sequence":"additional","affiliation":[{"name":"Department of Developmental Psychology and Research Methods, Institute of Psychology RWTH Aachen\u2010University Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Department of Social Work, Education, and Nursing University of Applied Sciences Esslingen Esslingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Mander","sequence":"additional","affiliation":[{"name":"Center for Psychological Psychotherapy, Institute of Psychology Ruprecht\u2010Karls\u2010University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1037\/pas0000031","article-title":"Child, Caregiver, and Therapist Perspectives on Therapeutic Alliance in Usual Care Child Psychotherapy","volume":"27","author":"Accurso E. 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