Examining the Alliance-Outcome Relationship: Reverse Causation, Third Variables, and Treatment Phase Artifacts

Psychotherapy research reveals consistent associations between therapeutic alliance and treatment outcomes in the youth and adult literatures. Despite these consistent findings, prospective associations are not sufficient to support the claim that the alliance is a change mechanism in psychotherapy. The current study examined the direction of effect of the alliance- outcome relationship, the contribution of early symptom change in treatment to the development of therapeutic alliance, and the potential for pretreatment interpersonal functioning characteristics to be third variables that account for the association between alliance and outcome. Participants were adolescents with depression and a history of interpersonal trauma that presented to a community mental health center for treatment. Findings demonstrated that a more positive therapeutic alliance predicted greater subsequent symptom improvement, even after removing symptom change occurring before the measurement of alliance. Results also suggested that early change only slightly contributed to alliance development. Finally, though pretreatment interpersonal functioning was related to the first session alliance, these pretreatment client characteristics were not related to later alliance or symptom change. Overall, results provided some support for therapeutic alliance as a mechanism of change in psychotherapy. Methodological and clinical issues are discussed.

Reverse Vending Machines: A Potential Solution for the Florida Plastic Waste Management Challenge

The waste of plastic beverage bottles creates environmental problems and takes up a large volume of landfill space. The high rate of consumption of plastics in the State of Florida is challenging the disposal capacity of waste authorities. The lack of the reverse vending machines in the State of Florida, including applicable scientific or technical literature represented an opportunity for this research to discuss the applicability of this equipment as a potential solution for the management of the plastic waste in Florida. With this research document, I will propose a recycling system for plastic bottles made with PET based on the implementation of reverse vending machines, stressing the importance of the creation of policies that promote recycling and public participation.