The Implications of “Working Alliance” for the Measurement and Evaluation of Family-centered Practice in Childhood Disability Services

Family-centered practice in childhood disability services has been found to be positively related to consumer satisfaction. This study explores the relationship between family-centered practice and parental satisfaction with services, while controlling for the quality of the relational dimension or “working alliance” between professionals and parents. Mothers of young children who were 4 years of age on average and with developmental and cognitive disabilities were surveyed in 103 Canadian families after they had been receiving community-based services for approximately 18 months. Hierarchical regression analyses showed that family-centered practice continued to be strongly related to positive consumer satisfaction with child disability services, even when the influence of working alliance was controlled. This finding was consistently found when 2 well-established measures of “family-centeredness” (Measure of Processes of Care-20 and Family Centered Behavior Scale) were independently utilized to evaluate the delivery of childhood disability services. Findings suggest that “working alliance” is a unique practice element that appears to operate in concert with family-centered methods in the achievement of positive consumer satisfaction when delivering family-centered childhood disability services.