The Integrative Psychotherapy Alliance model brought an interpersonal and systemic perspective to bear on theory, research, and practice on the psychotherapeutic alliance. Questions have been raised about the independence of the theoretical factors in the model and their operationalization in the Individual, Couple, and Family Therapy Alliance Scales. This paper presents results of a confirmatory factor analysis of the scales that delineated at least three distinct interpersonal factors as well as shorter versions of the three scales to facilitate their use in research and practice. The paper also presents the results of a study testing each factor's association with client retention and progress over the first eight sessions in individual and couple therapy. At least two of the interpersonal factors were uniquely associated with progress in individual and couple functioning. Implications of the results for theory, research, practice, and training in individual, couple, and family therapy are elaborated.
This study examined the ability of the therapeutic alliance to predict treatment progress on individual- and relationship-level variables from the early to middle phase of couple treatment. Although alliance did not predict progress in individual functioning, it accounted for 5-22% of the variance in improvement in marital distress. Women's mid-treatment alliance uniquely predicted improvement in marital distress, over and above early treatment alliance. When men's alliances with the therapist were stronger than their partners' at session 8, couples showed more improvement in marital distress. Treatment response was also positively associated with women's ratings of their partners' alliance. Results confirm that the therapeutic alliance in conjoint treatment is composed of distinct client subsystems that are useful predictors of treatment progress.
This article details the development and methodological characteristics of the Systemic Therapy Inventory of Change (STIC), the first measurement system designed to assess change in family, couple, and individual therapy from a multisystemic and multidimensional perspective. The article focuses specifically on the developmental process that resulted in the five valid and reliable scales that comprise the core measure of the system, the INITIAL STIC, which is administered to clients just before beginning therapy. The scales focus on five systemic domains: individual adult, family of origin, couple, family, and individual child. This article describes the five system scales, the results of the factor analytic process that created them, as well as data on their convergent and discriminant validity.
This study examines the predictive validity of several clinical variables--including marital distress, individual symptomatology, and family-of-origin experiences--on the formation of the alliance in couple therapy. Eighty people who were treated with a naturalistic course of integrative conjoint psychotherapy at a large midwestern outpatient clinic were assessed on the clinical variables before session 1. They also completed ratings of the therapeutic alliance after sessions 1 and 8. Individual symptomatology did not predict alliance formation at either treatment stage. Higher levels of marital distress predicted poorer alliances to treatment between partners at session 1. Marital distress also predicted therapeutic alliance quality for men and women at session 8. Family-of-origin distress predicted alliance quality for men at session 1, and for women at session 8. Family-of-origin distress for men and women predicted split alliances early in treatment, and marital distress predicted split alliances for women at session 8. Clinical implications for the assessment and treatment of couples are discussed.
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