Thesis (D. Min.)--Gordon-Conwell Theological Seminary, 2004. / Abstract and vita. Includes bibliographical references (leaves 100-116).

Texte remanié de: Diss. Ph. D.--Belfast--Queen's University, 1998. / Bibliogr. p. 268-292. Index.

Diss.--Åbo akademi university. / Bibliogr. p. 347-385. Index.

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Therapeutic alliance is an umbrella term referring to core aspects of the interaction and relationship between patient and practitioner during treatment. It has long been considered an important component of success in psychological and medical treatments. A survey of practitioners in child mental health (Kazdin, 1997) found that 95% thought that the relationship with the patient was the most important predictor of treatment outcome; there is research evidence suggesting the significant impact of alliance quality on outcome in adults and children, for both psychological (Martin et al., 2000, Shirk and Karver, 2003; Shirk, Karver and Brown, 2011) and general medical (Burkitt-Wright et al., 2004) treatments. Alliance, however, has been relatively little researched in childhood and until recently the emphasis (in both research and training) has been much more on the protocol details of treatment methods as opposed to detailed understanding of treatment process and the practitioner-patient relationship. Studies reporting associations between therapeutic alliance and treatment outcome have often been weakened by methodological difficulties in measurement and have failed to settle the direction of causality between symptom change and alliance (Kazdin and Nock, 2003). In treatment trials, alliance is often only measured in the experimental arm; this makes analysis of its effect difficult (Dunn and Bentall, 2007, and Emsley et al., 2010).This study represents an exceptional opportunity to address these limitations. It makes use of data collected during one of the most rigorous recent studies done in child mental health in the UK (Goodyer et al., 2007). This enables detailed study of the therapeutic relationship during treatment and allows testing of the effects of this relationship on the success of treatment. Sessional audiotapes were available within both arms of this trial. Purposeful selection of tapes from both arms of the trial during treatment were transcribed and rated for treatment alliance. Other data already collected in the trial was included in an analysis to address questions of direction of causality of alliance in relation to symptom change during treatment and the way that alliance may explain treatment effect heterogeneity.The results indicate a complex effect of alliance upon outcome. There is a relationship between early alliance score and clinical improvement, but the relationship is not straightforward and the predictive effect of alliance appears to depend on differences in patient groups and therapist effects. Analysis of treatment effect heterogeneity suggests that therapeutic alliance is associated with the individual treatment effect and implies that with poor alliance, more treatment may be detrimental. The complexities of the results are discussed with reference to implications for further research in this area as well as clinical practice.

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Nowadays, firms increasingly rely on strategic alliances to reach out for unique technological knowledge that firms cannot develop internally. However, in previous literature, we find inconsistent findings regarding the drivers and outcomes of a firm's leverage of alliance partners' technological knowledge. In this dissertation, I consider opposite propositions in prior studies simultaneously and examine two research questions: 1) what motivates a firm to search technological knowledge from alliance partners? And 2) how configurations of alliance knowledge and alliance network affect firm innovation? I argue that alliance knowledge search motivation is determined by the allocation of managerial attention to local domains and distant domains. While distant attention motives alliance knowledge search, local attention suppresses the motivation. I hypothesize that innovation performance below the aspiration level intensifies both local and distant attentions and has an inverted U-shaped relationship with alliance knowledge search intensity. This curvilinear relationship is moderated by the focal firm's knowledge stock size since firms with large knowledge stock are more likely to develop distant attention in the presence of poor innovation performance. I further argue that exploration and exploitation play key roles in the configurations of both alliance knowledge and alliance network. Alliance knowledge leveraging can contribute more to firm innovation, if the firm can establish a balance between exploration and exploitation. I propose that balancing exploration and exploitation within a single domain (e.g., search moderately explorative alliance knowledge) generates great managerial costs. However, firms can balance exploration and exploitation across domains: they can leverage explorative knowledge through exploitative alliances, such as repeated partnerships and strong ties. I test related hypotheses using longitudinal data from the U.S. biopharmaceutical industry. Results show that: 1) innovation performance below the aspiration level has an inverted U-shaped relationship with alliance knowledge search, demonstrating that both distant and local attention play important roles in developing the motivation for alliance knowledge search; 2) increasing knowledge stock size increases both positive and negative effects of innovation performance below aspiration; 3) technological distance of searched alliance knowledge has a linear negative effect on firm innovation; and 4) leveraging explorative knowledge from repeated partnership, but not strong ties, leads to superior innovation performance, supporting the idea of establishing the balance across domains. The findings make important contributions to alliance knowledge leveraging, aspiration, and exploration-exploitation literatures. The managerial implications of the study are also discussed. / Ph. D. / Nowadays, firms increasingly rely on strategic alliances to reach out for unique technological knowledge that firms cannot develop internally. By absorbing and utilizing these unique technologies, firms leverage alliance knowledge for their own technological innovation. However, in previous literature, we find inconsistent findings regarding the drivers and outcomes of alliance knowledge leverage. In this dissertation, I consider opposite propositions in prior studies simultaneously and examine the motivations and outcomes of a firm’s alliance knowledge leverage. First, I propose that the firm’s poor innovation performance is an important antecedent of alliance knowledge leverage. I hypothesize that, when a firm’s innovation performance is below the aspiration level, <i>i.e.</i>, below the firm’s past innovation performance and/or the average innovation performance of peer firms, further innovation performance decrease would first increase and then decrease the firm’s alliance knowledge search intensity. Moreover, a firm with a larger knowledge stock would conduct more alliance knowledge search to respond to innovation performance decrease than a firm with a smaller knowledge stock. Second, I examine how alliance knowledge leverage influence firm innovation. I argue that alliance knowledge leveraging can contribute more to firm innovation, if the firm can establish a balance between exploration, which is captured by terms such as search, variation, risk-taking, and experimentation, and exploitation, which is defined as items regarding experiential refinement and reusing existing knowledge. I propose that balancing exploration and exploitation within a single domain (e.g., search moderately explorative alliance knowledge) generates great managerial costs. However, firms can balance exploration and exploitation across domains: they can leverage explorative knowledge through exploitative alliances, such as repeated partnerships and strong ties. I test related hypotheses using longitudinal data from the U.S. biopharmaceutical industry. Results of data analysis generally support the hypotheses.

Thesis advisor: Robert S. Ross / This dissertation presents a structured and focused comparison of how Chinese leaders and academics have perceived the security cooperation of states on China’s periphery. This study examines three cases: the U.S.S.R.-Vietnam Alliance (1978-1989); the U.S.-Japan Alliance (1990-2016) and the U.S.-South Korea Alliance (1990-2016). They exemplify adversarial alliances in that they represent security cooperation that threatened or potentially threaten Chinese vital interests. Similarly, they all represent adversarial alliances of an asymmetric power relationship between a larger and smaller state. I gathered this data from Chinese journal articles and books related to the three cases, interviewed Chinese academics and think tank analysts, and compared the Chinese perceptions with non-Chinese primary and secondary sources. The research explores how well four concepts describe alliance behavior in the evidence. The first three concepts relate to how China views the alliances’ intentions, capabilities, and cohesion. The fourth concept relates to China’s self-perception as a rising state relative to the adversarial alliances. Knowledge of Chinese past and present perceptions of adversarial alliances should assist academics and policy makers in understanding the implications of security cooperation of states that are in close proximity to the Chinese mainland. / Thesis (PhD) — Boston College, 2016. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Political Science.