# Therapists’ perceptions of alliance barriers in the parent–therapist relationship when treating children who have experienced trauma

## TL;DR

This study explores how therapists perceive challenges in working with parents of children who have experienced trauma, highlighting the importance of trauma-informed practices to improve treatment outcomes.

## Contribution

The study identifies specific barriers in the parent–therapist relationship and emphasizes the need for trauma-informed therapist training to improve child therapy outcomes.

## Key findings

- Therapists identified reduced parent investment and parent trauma as key alliance barriers.
- Trauma-informed frameworks help therapists moderate obstacles in the parent–therapist relationship.
- Improved therapist knowledge of trauma theory can enhance child treatment outcomes.

## Abstract

Childhood experiences of traumatic events are common in all countries, and children may require psychotherapy after a traumatic experience. For those children who have experienced trauma and are involved in therapy, the parent–therapist relationship is important in promoting child trauma recovery. However, alliance barriers can interrupt the working relationship, compromising child treatment efficacy. Few studies have explored therapists’ perceptions of the complexities in the parent–therapist relationship when treating children for trauma.

This exploratory study uses trauma theory to understand obstacles interfering with the parent–therapist alliance. Qualitative research methods were used to explore data obtained from 15 therapists. An interpretive phenomenological research design supported the study to answer the research question.

Therapists were motivated to work with parents, as they recognise the important role of parents in treatment. They identified alliance barriers as reduced parent investment, parent trauma and therapists’ emotions. Therapists also applied a trauma-informed framework to moderate alliance obstacles preventing them from impacting child treatment success.

The findings highlight that therapists require knowledge of trauma theory and expertise in trauma-informed practice to work effectively with parents when treating children for trauma. This new knowledge will help therapists manage and support the parent–therapist relationship when treating children who have experienced trauma, improving long-term treatment outcomes of child psychotherapy.

What is already known about this topic:
Childhood experiences of trauma are universal, and children may require psychotherapy treatment.Evidence-based literature proves trauma-focused interventions are effective in treating child trauma, yet child attrition rates continue to be high.Positive parent–therapist alliances improve child psychotherapy success.

Childhood experiences of trauma are universal, and children may require psychotherapy treatment.

Evidence-based literature proves trauma-focused interventions are effective in treating child trauma, yet child attrition rates continue to be high.

Positive parent–therapist alliances improve child psychotherapy success.

What this topic adds:
This exploratory research study identifies alliance barriers in the parent–therapist relationship when working with parents of children who have experienced trauma.The research provides practitioners with new information on the complexities and tensions occurring in the parent–therapist relationship when treating children after traumatic experiences.Therapists can use this new understanding to better manage and support parents in the working alliance to improve child retention rates and outcomes.

This exploratory research study identifies alliance barriers in the parent–therapist relationship when working with parents of children who have experienced trauma.

The research provides practitioners with new information on the complexities and tensions occurring in the parent–therapist relationship when treating children after traumatic experiences.

Therapists can use this new understanding to better manage and support parents in the working alliance to improve child retention rates and outcomes.

Preliminary recommendations:
Child psychotherapists need knowledge and expertise in trauma-specific practices to work effectively with parents when treating children who have experienced trauma.Future research can compile guidelines for therapists on how to work more effectively with parent trauma survivors.

Child psychotherapists need knowledge and expertise in trauma-specific practices to work effectively with parents when treating children who have experienced trauma.

Future research can compile guidelines for therapists on how to work more effectively with parent trauma survivors.