The current study tested factors that could influence both youth and therapist-reported therapeutic alliance in 58 male adolescents ranging in age from 15 to 18 years old (M = 16.81, SD = 1.02) who were adjudicated for a delinquent offense and identified as needing mental health treatment. Therapeutic alliance was assessed through self-report by both the adolescent and therapist. Callous-unemotional (CU) traits and antisocial history were assessed through self-report and official record review respectively. Results indicated that the number of previous offenses was negatively associated with adolescent-reported therapeutic alliance but this was qualified by an interaction between antisocial history and CU traits. In those low on CU traits, there was a negative but non-significant association between number of previous offenses and the quality of the therapeutic alliance, whereas the association was significant and positive for those high on CU traits. In addition, CU traits were associated with violent institutional infractions during treatment. Thus, the combination of high CU traits and a high number of previous offenses seemed to reflect a group of adolescents who reported more positive therapeutic alliances but still had violent institutional infractions. These results provide support for tailored interventions for youth high on CU traits which consider the quality of the therapeutic relationship.
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