Child social and emotion functioning as predictors of therapeutic alliance in cognitive-behavioral therapy for anxiety.

Objective This study examined baseline child social and emotional functioning as predictors of therapeutic alliance during a cognitive-behavioral therapy (CBT) program for children with anxiety disorders. It was hypothesized that better social and emotional functioning at baseline would be related to stronger alliance initially and over the course of treatment. Method Ninety-two anxious youth, ages 7-11 years (M age = 8.93 years, SD = 1.64; 42% female) participated. Children, caregivers, and teachers completed measures of child social and emotional functioning. Therapeutic alliance was measured using therapist-rated and observer-coded reports. Results Receiving prosocial support from peers and emotion regulation (ER) were both related to initial rating and slope of alliance. Conclusions Child social and emotional functioning enhances our understanding of how the alliance is formed and in identifying children who might be at risk for difficulties in developing a strong therapeutic relationship.