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This study aimed to examine whether children's pre\u2010treatment attachment security and reflective functioning (\n                      <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>\n                      ) skills predict the strength of early therapeutic alliance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      The study was part of a randomized controlled trial measuring the effectiveness of Mentalization\u2010Based Treatment for Children (\n                      <jats:styled-content style=\"fixed-case\">MBT<\/jats:styled-content>\n                      \u2010C).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants were 71 children aged 7\u201312 who received the\n                      <jats:styled-content style=\"fixed-case\">MBT<\/jats:styled-content>\n                      \u2010C intervention. Pre\u2010treatment assessments included the Attachment Doll Story Completion Task to measure attachment security, and the Child Reflective Functioning Scale to assess\n                      <jats:styled-content style=\"fixed-case\">RF<\/jats:styled-content>\n                      skills. Early therapeutic alliance was evaluated at the third week of treatment using the self\u2010report scale of Therapeutic Alliance Scale for Children (both child and therapist forms).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results from the mediation model showed that children's reflective functioning skills significantly mediated the relationship between attachment security and early alliance rated by children. Therapist\u2010rated alliance was found to be insignificant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Findings highlight reflective functioning as a central mechanism linking attachment security to children's perceptions of therapeutic alliance in\n                      <jats:styled-content style=\"fixed-case\">MBT<\/jats:styled-content>\n                      \u2010C. This suggests that children's capacity to understand others' mental states is critical for establishing early alliance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papt.70100","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:03:07Z","timestamp":1787130187000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reflective functioning skills mediating the relationship between attachment security and therapeutic alliance in mentalization\u2010based treatment for children"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-0736","authenticated-orcid":false,"given":"Pelinsu Bulut","family":"\u00d6zer","sequence":"first","affiliation":[{"name":"Department of Psychology Istanbul Bilgi University  Istanbul T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-2024","authenticated-orcid":false,"given":"Z. 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