Development and Clinical Utility of an Optimized 12-ltem Alliance Rating Scale for Youth Psychotherapy
Location
LSUHSC-NO
Publication Date
April 2026
Start Date
9-4-2026 10:00 AM
End Date
9-4-2026 2:00 PM
Description
Background: Faculty have less time for direct observation of trainees learning psychotherapy, meaning less direct feedback. Patient feedback forms can assist trainees learning psychotherapy skills, which may lead to better outcomes for patients. To date, there are few validated assessment tools available, especially for child and adolescent therapists. This study addressed this need by identifying core feedback themes in the literature to develop an optimized 12-item rating scale. We plan to implement this scale within a community health clinic to evaluate its clinical utility and investigate whether higher scores correlate with objective symptom reduction, as measured by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales.
Methods: A search was done using Pub Med, Psyclnfo and Google Scholar to identify assessment tools of patient perception of therapy. Inclusion criteria were reliability across a range of modalities, those for youth populations and those that can be administered in the clinical setting. Common themes were identified and a 12-ltem rating scale was formed designed to measure rapport. Pending IRB approval, the scale will be deployed at community clinic every two months. Participants will include a DSM-5 diagnosis of Major Depressive Disorder or Generalized Anxiety Disorder between ages 7-18. Correlations in PHQ-9 and GAD-7 scores will be drawn.
Results: Key assessment tools identified in the search were: 1. Child Session Rating Scale (CSRS) 2. Working Alliance Inventory (WAI) 3. Helping Alliance Questionnaire (HAq-11) 4. Outcome Rating Scale (ORS) 5. Therapeutic Alliance Scales for Children (TASC) 6. Adolescent Feedback Form (AACAP)
Discussion: While multiple assessment tools were identified, they were not consistent in their measurements and failed to reliably translate to improved patient outcomes. To address this, an optimized 12-item rating scale was created using the most common themes and will be deployed in an outpatient setting. Data will be analyzed to determine whether an association exists between higher therapeutic alliance ratings and significant reductions in PHQ-9 or GAD-7 scores among youth with MDD or GAD. The optimized scale may both enhance the education of psychotherapy trainees and facilitate superior clinical outcomes.
Recommended Citation
Sapora, Riley MS3 and Foret, Rachel MD, "Development and Clinical Utility of an Optimized 12-ltem Alliance Rating Scale for Youth Psychotherapy" (2026). Dept. of Psychiatry Research Symposium. 28.
https://digitalscholar.lsuhsc.edu/psych_rd/2026/posters/28
Development and Clinical Utility of an Optimized 12-ltem Alliance Rating Scale for Youth Psychotherapy
LSUHSC-NO
Background: Faculty have less time for direct observation of trainees learning psychotherapy, meaning less direct feedback. Patient feedback forms can assist trainees learning psychotherapy skills, which may lead to better outcomes for patients. To date, there are few validated assessment tools available, especially for child and adolescent therapists. This study addressed this need by identifying core feedback themes in the literature to develop an optimized 12-item rating scale. We plan to implement this scale within a community health clinic to evaluate its clinical utility and investigate whether higher scores correlate with objective symptom reduction, as measured by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales.
Methods: A search was done using Pub Med, Psyclnfo and Google Scholar to identify assessment tools of patient perception of therapy. Inclusion criteria were reliability across a range of modalities, those for youth populations and those that can be administered in the clinical setting. Common themes were identified and a 12-ltem rating scale was formed designed to measure rapport. Pending IRB approval, the scale will be deployed at community clinic every two months. Participants will include a DSM-5 diagnosis of Major Depressive Disorder or Generalized Anxiety Disorder between ages 7-18. Correlations in PHQ-9 and GAD-7 scores will be drawn.
Results: Key assessment tools identified in the search were: 1. Child Session Rating Scale (CSRS) 2. Working Alliance Inventory (WAI) 3. Helping Alliance Questionnaire (HAq-11) 4. Outcome Rating Scale (ORS) 5. Therapeutic Alliance Scales for Children (TASC) 6. Adolescent Feedback Form (AACAP)
Discussion: While multiple assessment tools were identified, they were not consistent in their measurements and failed to reliably translate to improved patient outcomes. To address this, an optimized 12-item rating scale was created using the most common themes and will be deployed in an outpatient setting. Data will be analyzed to determine whether an association exists between higher therapeutic alliance ratings and significant reductions in PHQ-9 or GAD-7 scores among youth with MDD or GAD. The optimized scale may both enhance the education of psychotherapy trainees and facilitate superior clinical outcomes.