Suicide Prevention Initiatives
This aim focuses on understanding the relationships formed between a clinician/therapist and their client throughout the intervention process and the role these relationships serve in the success of interventions. This aim has expanded to include the relationship that is formed between trainers and trainees in prevention trainings. The following projects are currently underway:
This project involved the audiotaping of therapy sessions with depressed and suicidal adolescents on a previously funded grant. Each adolescent received 12 sessions of cognitive behavioral therapy, and tapes of these sessions have continued to be coded for aspects of the therapeutic alliance. Previous lab members developed a coding method that research assistants and other lab members are trained in to code segments of therapy sessions for predictors of the therapeutic alliance and outcome variables.
This study's principal goal is to develop an observational measure of adolescent therapeutic alliance and treatment participation to evaluate how these factors relate to participation, continuation, and treatment outcomes. Currently, most of the therapeutic alliance literature has focused on adults, and the principles of adolescent alliance were taken from adult findings. This study identifies the need for a measure of adolescent and child alliance that considers developmental changes unique to younger individuals.
This project began after the completion of a meta-analysis that examined the relationship between alliance and therapy outcomes in youth. Through this analysis, the research team discovered there were no materials that clinicians could use to help develop the skills necessary to form an alliance with a youth client. Therefore, we aim to create brief video clips and a corresponding manual to address this gap in the literature. We are currently working on a flowchart in which to organize all alliance-building behaviors identified. Once this phase of the project is complete, scripts will be written and used to model each alliance-building behavior.
Also stemming from the previously mentioned meta-analysis, this project aims to develop a new alliance measure to address a gap in the literature. A few years ago, a team of lab members generated a list of items for this new measure, divided into three categories: emotional, cognitive, and behavioral. Within each group, items were coded as contributing to high, medium, or low alliance. With these steps, the research team hopes to use IRT (Interactive Response Technology) to calibrate a computerized test that adjusts to a respondents' answers. To ensure we have an acceptable item pool and to account for the opinions of people who will be completing the measure, focus groups with adolescents who have experience with therapy will be conducted in the future.
Recently, the research team began a collaboration with Dr. Jean Rhodes at the University of Maryland, Baltimore. Dr. Rhodes studies mentoring, and her team has recently started developing materials to train mentors to form relationships with their mentees. We hope to develop a program that aids mentors in these alliance-building efforts by utilizing both her areas of expertise and our lab's. Meetings with Dr. Rhodes are begin held regularly as the research team develops an initial problem model.