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Minerva Psichiatrica 2004 September;45(3):115-26


language: Italian

Characteristic of pretreatment, alliance and outcome in psychotherapy of adolescents: a review of the literature

Finicelli C., Zita N. I., Colombo C.


The aim of this paper is to examine: the incidence of the pretreatment clinical characteristics in patients, expressed by the severity of the symptoms in the defensive style and in the global functioning, on the level of the alliance; the main trends of researches and empirical evaluation of the alliance; the characteristics of the alliance noticed in psychotherapies with adolescents, beginning from the first phases and the instruments used for its empirical evaluation. In the analysis of the literature we have pointed out the Italian monographs on the alliance and the studies published from the '90s in some Italian journals that have given a contribution to these subjects. Moreover, we have analysed the content of some computerised data banks (Medline, PsycINFO) using key words such as: alliance, alliance and defence mechanism, adolescence and therapeutic alliance or helping alliance or working alliance. The review has underlined the complexity of the concept of alliance developed over the time, its correlation with the psychotherapic process and its result. The number of studies carried out on alliance in psychotherapy with adolescents seems decreased, particularly in the lowest ranges of age (13-17 years) which are considered the most exposed to the risk of drop out, as well as the studies on the whole complete adolescent development course between 13 and 25 years. The possible correlation with the global functioning and defensive pretreatment has also been investigated. Moreover, there are few studies on the use of instruments for the empirical evaluation. Any-way, a general agreement on the existence of a correlation between a low level of alliance and the severity of symptoms present in adolescence, particularly in the organisational level of the ego, seems to be present in the studies examined.

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