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The question of the therapeutic alliance in clinical treatment of children necessarily enmeshes the alliance with the child with that of his or her parents. The ability to develop a therapeutic alliance with an autistic child is also questioned, in that the connection occurs outside of the process of differentiation between subject and object. Indeed, the construction of the therapeutic alliance involves a representational capacity and investment of the self and of the object which are gradually differentiated. Through the comparative study of two contrasting situations of children in post-autistic states, one who is evolving positively and the other less so, we will seek to identify some factors promoting or impeding the therapeutic alliance.