Her PhD research has explored one of the most important aspects of therapy – the relationship between therapist and client.

And Antonella Cirasola hopes the findings of her studies on the therapeutic alliance and its role in psychotherapy for adolescent depression will help shape therapeutic training in the future and ultimately improve psychotherapy for young people.

She is one of six PhD researchers to have benefited from a BACP doctoral bursary since 2017.

This year there’s another full-time PhD studentship opportunity available, which we’re jointly-funding with UKCP and York St John University. 

Antonella completed her PhD at University College London earlier this year.

Complex topic

She said: “The therapeutic alliance is considered an important mechanism of change in youth psychotherapy. Yet, alliance research with young people is scarce and hampered by limitations. It’s a complex topic to research, but it’s important to provide further insight into what makes psychotherapy work.

She added: “I really believe in the importance of the therapeutic relationship for the success of therapy, but I’m also well aware of the challenges there can be in fostering and maintaining an alliance with young people. It was an absolute pleasure to conduct research on this topic.”

Antonella Cirasolla

Antonella Cirasola

Antonella’s research used data from the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) database, one of the biggest ever randomised control trials looking at the use of therapy in the treatment of adolescent depression.

She carried out four specific studies as part of her PhD, with her findings challenging both the definition of the therapeutics alliance and assumptions about how the alliance is built.


Through her research, the development of trust emerged as one of the key elements needed for a good alliance.

Her results also challenged the assumption that the alliance is generic and found that the type of therapy can influence the strength of the alliance and its relationship with outcomes.

And her study found that the strength of the alliance early on in therapy can play an important role in determining outcomes, unrelated to the clients’ symptoms and severity of issues.

She’s had papers published as part of her PhD in Psychotherapy Research, The Journal of Psychotherapeutic Integration and Psychotherapy. Another paper is due to be published soon.

She believes the findings of her studies will have a range of implications for research, training and psychotherapy practice.


She adds: “I hope it will help lead to useful guidance regarding the therapeutic relationship - increasing knowledge of what factors and processes affect outcomes.

“Insight into these mechanisms of change, like the alliance and the process of repairing alliance ruptures, is directly relevant to improving psychotherapy for young people, as well as making mental health services more productive and cost-effective.”

Antonella now works as a senior research supervisor for a UCL MSc in Developmental Psychology and Clinical Practice, and a module lead for Clinical Skills. She’s also involved with the Anna Freud Centre’s school remote service, a new project developed in response to the COVID-19 pandemic, and has been awarded a grant to carry out some further research following on from one of the studies in her PhD.

Apply for a funded PhD

A full-time PhD studentship is available for a postgraduate research student to explore and evaluate routine outcome measurement (ROM) in counselling and psychotherapy practice. The PhD will be joint-funded by BACP, UKCP and York St John University. Find out more and apply for the PhD studentship opportunity.