Therapeutic Alliance and Group Cohesion Across Telehealth Delivery of Mentalizing-focused Parenting Groups

ABSTRACT

This study assessed changes in therapeutic alliance and group cohesion among parents/primary caregivers enrolled in Connecting and Reflecting Experience (CARE), a short-term, group-based, mentalizing-focused parenting program designed to support a diverse community facing socioeconomic and health disparities. Caregivers (N = 44) experiencing parenting stress or parent-child relational challenges were recruited from their children’s outpatient psychiatry clinic to participate in one of nine 12-session telehealth CARE groups. Caregivers completed the Working Alliance Inventory-Short Revised and the Therapeutic Factors Inventory Cohesiveness subscale after CARE Sessions 1 and 12. Ratings of group cohesion and therapeutic bond with facilitators increased significantly across treatment. Findings indicate that caregivers from underserved families with high levels of parenting stress experienced an increase in group cohesion and therapeutic alliance throughout a telehealth adaptation of CARE.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the FAR Fund & the National Institute of Mental Health of the National Institutes of Health, under Grant (R01MH126821).

Notes on contributors

Audrey Kucer

Audrey Kucer, Ph.D., is a licensed clinical psychologist at Heights Psychology Collective, where she treats primarily neurodiverse children and adolescents and their families. She received her doctorate in clinical psychology at the New School for Social Research and completed her internship training at Montefiore Medical Center. Her research interests focus on therapeutic action and processes routed in attachment theory and research that enhance parent-child relationships, particularly in families with significant trauma histories and high levels of psychosocial stress.

Olivia J. Derella

Olivia Derella, Ph.D., is an Attending Psychologist at Montefiore Medical Center/Albert Einstein College of Medicine. Dr Derella’s areas of clinical and research interest include emotion-related processes in caregiver-child relationships, parenting-focused interventions informed by both attachment theory and cognitive-behavioral approaches, and the developmental psychopathology and treatment of childhood irritability.

Anna Kilbride

Anna Kilbride, M.A., is a doctoral student in clinical psychology at the Graduate School of Applied and Professional Psychology at Rutgers University, a clinical research affiliate at the Yale Child Study Center, and a study coordinator at Montefiore Medical Center/Albert Einstein College of Medicine. She received her master’s degree in Child Development from Sarah Lawrence College, where her thesis examined representational risk markers in the attachment narratives of trauma-exposed, first-time mothers.

Amanda Zayde

Amanda Zayde, Psy.D., is the developer and director of the Connecting and Reflecting Experience (CARE) program, the codeveloper and codirector of the Becoming an Emerging Adult at Montefiore (BEAM) program, Associate Director of Psychology Training, and Assistant Professor of Psychiatry and Behavioral Sciences at Montefiore Medical Center/Albert Einstein College of Medicine. Dr Zayde is also Associate Training Director of Mothering from the Inside Out, an evidence-based parenting intervention designed specifically for mothers in recovery from substance use disorders. Dr Zayde’s primary areas of research include the use of mentalizing-focused parenting interventions to dismantle the intergenerational transmission of attachment trauma as well as the assessment and treatment of emerging adults.