References | Participants, study type and location | Findings | Strengths and limitations of study | Critical appraisal of study* |
---|---|---|---|---|
Bennett LR. Adolescent Depression: Meeting Therapeutic Challenges Through an Integrated Narrative Approach. J Child Adolesc Psychiatr Nurs. 2012;25(4):184–94 | N = 1 Male 14 years old Ethnicity: not reported | Collaborative goal setting influences therapeutic alliance via shared understanding of the difficulties, from the practitioner’s perspective. Goal setting is facilitative of good communication | Voice is given to the young person through the research, however, the study is primarily from the practitioner’s perspective | Credibility: some evidence (verbatim quotes) |
Major depressive episode with anxiety | Single case example | Transferability: caution advised when applying to other contexts | ||
Narrative case study | Emphasis on flexible working, via goals, to meet personal needs | Full demographics not reported | Dependability: not evidenced | |
Canada | Western high-income country | Confirmability: not evidenced | ||
Berdondini L, Elliott R, Shearer J. Collaboration in Experiential Therapy. J Clin Psychol. 2012;68(2):159–67 | N = 1 Male 20 years old Ethnicity: European | Notes that there is no alliance without collaboration. Collaboration (goals and tasks) should be agreed with the client to ensure (1) Optimal working with their experiences; (2) Autonomy and acceptance of responsibility for own experiences/actions; (3) Completion of important therapeutic work | Voice is given to the young person through the research, however, the study is primarily from the practitioner’s perspective | Credibility: not evidenced |
Social anxiety | Case showed that productive collaboration is not necessarily natural or spontaneous but requires efforts of both the young person and practitioner to take emotional/interpersonal risks by disclosure of a genuine manner | Single case example | Transferability: caution advised when applying to other contexts | |
Narrative case study | Full demographics not reported | Dependability: not evidenced | ||
UK | Goals are a conduit for good communication and increase engagement | Western high-income country | Confirmability: not evidenced | |
Cirasola A, Midgley N, Fonagy P, Martin P, M Goodyer I, Reynolds S, et al. The factor structure of the Working Alliance Inventory short-form in youth psychotherapy: an empirical investigation. Psychother Res [Internet]. 2021;31(4):535–47 | N = 465 11–17 years (M = 15.5) Ethnicity: Majority White British (~ 74%) | Findings suggest that agreement on goals may be challenging in an age group who are often referred for therapy by others, and may not see difficulties “in” themselves, and developmental needs may interfere with the establishment of collaborative relationships with adults | Therapeutic alliance was rated over several time points | Credibility: good evidence |
Depression | Focus of the study was young people’s ratings on a therapeutic alliance tool (WAI-S) | Transferability: caution advised when applying to other contexts | ||
Randomised control trial assessing the effects of three therapeutic interventions in the treatment of adolescent depression | High levels of collaboration (goals and tasks) foster the development of a strong bond | Participants recruited from multiple settings | Dependability: some evidence | |
Unable to control for variance at the client or practitioner level | Confirmability: not evidenced | |||
UK | Western high-income country | |||
Diamond GM, Diamond GS, Liddle HA. The therapist–parent alliance in family‐based therapy for adolescents. J Clin Psychol. 2000;56(8):1037–50 | N = 1 Male 15 years old Ethnicity: White | Goal formulation is described as an important element of building therapeutic alliance. In the goal-formation phase, the practitioner aims to establish relationship building as the initial objective of therapy | Voice is given to the young person through the research, however, the study is primarily from the practitioner’s perspective | Credibility: some evidence (verbatim quotes) |
Depression | Single case example | Transferability: caution advised when applying to other contexts | ||
Narrative case study | Findings suggest that through specific goal setting, it is possible to increase disclosure, the sharing of vulnerable emotions, and mutual support between parent – young person – practitioner triads, during later conjoint conversations about difficult, relational themes | Western high-income country | Dependability: not evidenced | |
Israel | Goal setting with parents/carers can facilitate open communication with young people | Confirmability: not evidenced | ||
Feltham A, Martin K, Walker L, Harris L. Using goals in therapy: The perspective of people with lived experience. In: M. Cooper & DL, editor. Working with goals in psychotherapy and counselling. Oxford: Oxford University Press; 2018. p. 73–85 | “Young people” or “young adults” age not defined | Agreeing goals in therapy is of key importance to young people, for communication: to enable them to feel heard, and that practitioners are listening to them | Narrative review incorporating quotes and examples from young people/young adults with lived experience enables important voices to be centralised in this research | Credibility: some evidence (verbatim quotes) |
Anxiety and depression are discussed as well as other difficulties | Transferability: caution advised when applying to other contexts | |||
Narrative review of people with lived experience of mental health difficulties and therapeutic interventions | Low confidence or feelings of hopelessness and poor previous experiences of goal setting are limiting factors for prospective goal setting | Full demographics not reported | Dependability: not evidenced | |
UK | Western high-income country | Confirmability: some evidence | ||
Law D, Wolpert M. Guide to using outcomes and feedback tools with children, young people and families. Formally known as the COOP document. London: CAMHS Press; 2014 | “Young people” or “young adults” age not defined | Discusses the importance of building good therapeutic relationships, and cites goals as a central element of this. Provides quotes from young people based on their experiences of setting goals in therapy | Guidance for practitioners based on focus groups with practitioners and young people, incorporating quotes and examples from young people with lived experience enables important voices to be centralised in this research | Credibility: some evidence (verbatim quotes) |
Anxiety and depression are discussed as well as other difficulties | Transferability: caution advised when applying to other contexts | |||
Guidance document for practitioners for using feedback and outcome tools with children and young people in therapeutic settings | Reviewing progress towards goals too frequently in long-term therapy could give the young person the impression that the practitioner is more interested in gauging their own success, rather than being interested in them as a whole person | Full demographics not reported | Dependability: not evidenced | |
UK | Young people in long-term therapy may have difficulty engaging in goal setting. This is due to the potential of having experienced significant and repeated traumas which have impacted on their development | Western high-income country | Confirmability: not evidenced | |
Martin K. A critical realist study of shared decision-making in young people’s mental health inpatient units. 2019. Doctoral Thesis. UCL | N = 16 Female N = 10 Male N = 5 Gender fluid N = 1 15–17 years (M = 16.2) Ethnicity: Bangladeshi British N = 1 Black African N = 1 Black British N = 1 British Romanian N = 1 Latino N = 1 White British N = 10 White Other N = 1 | Findings emphasise the importance of building good therapeutic alliances and this study cites goals as a central element of shared decision making. The findings include quotes from young people based on their experiences of setting goals within the inpatient setting | The focus on qualitative interviews with young people enables important voices to be centralised in this research | Credibility: some evidence (verbatim quotes) |
Anxiety and depression and several other mental health difficulties | Sample recruited from two settings | Transferability: caution advised when applying to other contexts | ||
Naturalistic study based in two inpatient mental health units | The importance of a collaborative way of setting goals was expressed as a key element of ensuring goals is an effective element of helping, such that the collaboration of the practitioner is key to ensure the young person is setting achievable goals. Goals are a facilitator of good communication and a shared understanding of ways forward | Primarily White British sample and study conducted in a Western high-income country | Dependability: good evidence | |
UK | Receiving feedback on progress towards goals is seen as a key motivator and provides validation that goals are meaningful and achievable | Confirmability: good evidence |