{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:24:39Z","timestamp":1789680279008,"version":"4.0.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>An important determinant of therapy outcome is the quality of the therapeutic relationship. This study evaluated the association between the client\u2019s assessment of first-session therapeutic relationship (FSTR) and outcome in an intensive treatment for adolescents with personality disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients (N = 92) were measured weekly during intensive group treatment. The therapeutic relationship was measured with the Child version of the Session Rating Scale (C-SRS) that was completed after each group therapy session by the patient. Outcome was measured with the Child version of the Outcome Rating Scale (C-ORS). Reliable change index (RCI) was calculated for the both instruments to determine significant changes in therapeutic relationship and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A good FRST gave twice as much chance of a significantly better outcome. Especially for those with moderate FSTR, establishing and maintaining a good working relationship during treatment could increase the chances of a good outcome considerably. In contrast, adolescents with low FSTR had little chance of positive outcome regardless of any improvement in the therapeutic relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adolescents assessment of FRST is indicative of the chance of a good outcome.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2022.916888","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T16:22:45Z","timestamp":1655396565000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["First-Session Therapeutic Relationship and Outcome in High Risk Adolescents Intensive Group Psychotherapeutic Programme"],"prefix":"10.3389","volume":"13","author":[{"given":"Kirsten","family":"Hauber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Boon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"B1","year":"2013","journal-title":"Diagnostic and Statistical Manual of Mental Disorders"},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1093\/med\/9780198570905.001.0001","author":"Bateman","year":"2006","journal-title":"Mentalization based treatment for borderline personality disorder: A practical guide."},{"key":"B3","author":"Bateman","year":"2012","journal-title":"Handbook of mentalizing in mental health practice."},{"key":"B4","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/s12485-012-0008-y","article-title":"De Child outcome rating scale (C-ORS) en de Child session rating scale (C-SRS). Het belang van de therapeutische alliantie voor het behandelresultaat. [The Child outcome rating scale (C-ORS) and the Child session rating scale (C-SRS). The importance of the therapeutic alliance for treatment outcome].","volume":"38","author":"Boon","year":"2012","journal-title":"Tijdschrift voor Psychotherapie"},{"key":"B5","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1037\/h0085885","article-title":"The generalizability of the psychoanalytic concept of the working alliance.","volume":"16","author":"Bordin","year":"1979","journal-title":"Psychotherapy: Theory, Res. Pract."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/13284200802676391","article-title":"Outcome Rating Scale and Session Rating Scale in psychological practice: clinical utility of ultra-brief measures.","volume":"13","author":"Campbell","year":"2009","journal-title":"Clin. Psychol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/j.cpr.2013.04.005","article-title":"A meta-analytic review on treatment dropout in child and adolescent outpatient mental health care.","volume":"33","author":"De Haan","year":"2013","journal-title":"Clin. Psychol. Rev."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/17542863.2013.789918","article-title":"Ethnic differences in DSM\u2013classifications in Youth Mental Health Care practice.","volume":"2014","author":"De Haan","year":"2014","journal-title":"Internat. J. Cult. Ment. Health"},{"key":"B9","first-page":"3","article-title":"The Session Rating Scale: preliminary psychometric properties of a \u2018working\u2019 alliance measure.","volume":"3","author":"Duncan","year":"2003","journal-title":"J. Brief Ther."},{"key":"B10","first-page":"71","article-title":"Giving Youth a Voice: a Preliminary Study of the Reliability and Validity of a Brief Outcome measure for Children Adolescents, and Caretakers.","volume":"5","author":"Duncan","year":"2006","journal-title":"J. Brief Ther."},{"key":"B11","year":"2017"},{"key":"B12","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1037\/pst0000172","article-title":"The alliance in adult psychotherapy: a meta-analytic synthesis.","volume":"55","author":"Fl\u00fcckiger","year":"2018","journal-title":"Psychotherapy"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1037\/int0000190","article-title":"Psychotherapy techniques related to therapist alliance among adolescents with eating disorders: the utility of integration.","volume":"2019","author":"Groth","year":"2019","journal-title":"J. Psychother. Integr."},{"key":"B14","author":"Hafkenscheid","year":"2006","journal-title":"Child Sessions Rating Scale, Dutch version. Sinai Centrum."},{"key":"B15","first-page":"1","article-title":"The Outcome and Session Rating Scales: a cross-cultural examination of the psychometric properties of the Dutch translation.","volume":"7","author":"Hafkenscheid","year":"2010","journal-title":"J. Brief Ther."},{"key":"B16","first-page":"45","article-title":"Mentaliseren en de kwetsbare adolescent.","volume":"37","author":"Hauber","year":"2010","journal-title":"Kinder Jeugd Psychotherapie"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-017-0197-9","article-title":"Examining changes in personality disorder and symptomology in an adolescent sample receiving intensive mentalization based treatment - a pilot study.","volume":"11","author":"Hauber","year":"2017","journal-title":"Child Adolesc. Psychiat. Ment. Health"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.533903","article-title":"Therapeutic relationship and dropout in high risk adolescents intensive group psychotherapeutic programme.","volume":"11","author":"Hauber","year":"2020","journal-title":"Front. Psychol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14616734.2018.1529808","article-title":"Adolescent attachment insecurity and the influence of MBT.","volume":"2018","author":"Hauber","year":"2018","journal-title":"Attach. Hum. Dev."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-019-0263-6","article-title":"Therapeutic factors that promote recovery in high-risk adolescents intensive group psychotherapeutic MBT programme.","volume":"13","author":"Hauber","year":"2019","journal-title":"Child Adolesc. Psychiatry Ment. Health"},{"key":"B21","year":"2017","journal-title":"IBM SPSS Statistics for Windows, Version 25.0."},{"key":"B22","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1037\/0022-006X.59.1.12","article-title":"Clinical Significance: a Statistical Approach to Defining Meaningful Change in Psychotherapy Research.","volume":"59","author":"Jacobson","year":"1991","journal-title":"J. Consult. Clin. Psychol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1080\/10503307.2016.1152408","article-title":"Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.","volume":"27","author":"Janse","year":"2017","journal-title":"Psychother. Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1037\/pst0000176","article-title":"Meta-analysis of the prospective relation between alliance and outcome in child and adolescent psychotherapy.","volume":"55","author":"Karver","year":"2018","journal-title":"Psychotherapy"},{"key":"B25","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1001\/archpsyc.62.6.617","article-title":"Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication.","volume":"62","author":"Kessler","year":"2005","journal-title":"Archiv. Gen. Psychiatry"},{"key":"B26","author":"Miller","year":"2004","journal-title":"The outcome and session rating scale. Administration and scoring manual."},{"key":"B27","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1037\/pst0000193","article-title":"Psychotherapy Relationships That Work III.","volume":"55","author":"Norcross","year":"2018","journal-title":"Psychotherapy"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000035","article-title":"The Working Alliance in Treatment of Military Adolescents.","volume":"84","author":"Owen","year":"2016","journal-title":"J. Consult. Clin. Psychol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1016\/j.jaac.2012.09.018","article-title":"Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial.","volume":"51","author":"Rossouw","year":"2012","journal-title":"J. Am. Acad. Child Adoles. Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1017\/S0033291707001511","article-title":"Effectiveness of cognitive-behavioural, person-centred, and psychodynamic therapies in UK primary-care routine practice: replication in a larger sample.","volume":"38","author":"Stiles","year":"2008","journal-title":"Psycholog. Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1037\/a0027776","article-title":"Therapist perspectives on the use of feedback on process and outcome: Patient-focused research in practice.","volume":"53","author":"Sundet","year":"2012","journal-title":"Can. Psychol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.cpr.2017.04.005","article-title":"The application of a feedback-informed approach in psychological service with youth: systematic review and meta-analysis.","volume":"55","author":"Tam","year":"2017","journal-title":"Clin. Psychol. Rev."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00787-020-01503-w","article-title":"A dual perspective on first-session therapeutic alliance: strong predictor of youth mental health and addiction treatment outcome.","volume":"2020","author":"van Benthem","year":"2020","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"B34","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1002\/wps.20609","article-title":"The evidence-based group-level symptom-reduction model as the organizing principle for mental health care: time for change?","volume":"18","author":"van Os","year":"2019","journal-title":"World Psychiatry"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.916888\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T16:23:00Z","timestamp":1655396580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.916888\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,16]]},"references-count":34,"alternative-id":["10.3389\/fpsyg.2022.916888"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2022.916888","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,16]]},"article-number":"916888"}}