Random effects model

Political science

Mathematics

Moderation

Internal medicine

Alliance

Medicine

Confidence interval

Mental health

Psychotherapist

Clinical psychology

Meta-analysis

Statistics

Psychology

Multilevel model

Social psychology

Journal of Child Psychology and Psychiatry

Background Previous meta‐analyses have only found small correlations ( r = .10 to r = .19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study‐level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta‐analysis aimed to address this gap by using patient‐therapist ratio as a moderator variable. Methods Contrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a preregistered conceptual hierarchy. Controlling for treatment‐level confounds, a random effects meta‐analysis assessed the moderating effect of patient‐therapist ratio on the alliance‐outcome relationship in predefined single‐predictor and multipredictor meta‐regressions. Results The alliance‐outcome relationship was found to be larger than previously thought ( k = 28, N = 2,911, r = .29, 95% Confidence Interval 0.21, 0.37; p &lt; .0001, I 2 = 80%). When study samples exceedin...

Practitioner Review: Therapist variability, patient‐reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta‐analysis