Date of Submission


Degree Type


Degree Name

Doctor of Psychology (PsyD)



Department Chair

Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology

First Advisor

Elizabeth A Gosch, PhD, ABPP

Second Advisor

Susan Panichelli Mindel, PhD

Third Advisor

Vanessa K Johnson, PhD


The importance of alliance in therapy has been well documented. This study explored specific therapist behaviors and their relationship to child perceived alliance and outcome in a randomized controlled trial of a cognitive-behavioral treatment for youth anxiety disorders. Participants included 42 youth (male = 24; female = 18; Caucasian = 37; African American = 4; Hispanic = 1) between the ages of 7 and 13 years who met criteria for a principal anxiety diagnosis. The study examined the sample as a whole, as well as focused specifically on youth diagnosed with social phobia. Videos of the first session of treatment were coded for the presence of 11 therapist behaviors (seven positive and four negative) using the Therapist Alliance Building Behaviors Scale (TABBS). The results indicated that negative-valance therapist behaviors predicted perceived alliance in children who had a principal anxiety diagnosis other than social phobia. Findings suggest that avoiding negative behaviors may have more of an effect on alliance than engaging in positive behaviors with some populations. Future research should continue to identify therapist behaviors that might contribute to or rupture a working alliance in the youth population.

Included in

Psychology Commons