Factorial and Construct Validity of the Revised Short Form Integrative Psychotherapy Alliance Scales for Family, Couple, and Individual Therapy

Abstract

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.

The working alliance: Where have we been, where are we going?

“…Limitations of this review include a lack of attention to the working alliance construct in specific populations or types of therapy, including child/ adolescent (McLeod, 2011) and couples and family therapy (Pinsof et al, 2008). An in-depth discussion of the impact of different reporters and the convergence of patient, therapist, and observer-based measures was also beyond the scope of this paper.…”

“…Of note, measures also exist that extended beyond the individual psychotherapy paradigm, including the Couple Therapy Alliance Scale and the Family Therapy Alliance Scale (CTAS and FTAS; Pinsof & Catherall, 1986). The most recently revised versions of these measures include the CTAS RevisedShort Form (CTASr-SF) and FTAS Revised-Short Form (FTASr-SF), which include interpersonal dimensions of the alliance and assess the perception of significant others of the therapeutic relationship (Pinsof, Zinbarg, & Knobloch-Fedders, 2008).…”

Attachment as a Predictor of the Therapeutic Alliance in Couple Therapy

“…Quinn, Dotson, and Jordan (1997) stated that "with two or more clients, couple and family therapy creates a social field that presents unique challenges, demands, and processes not found in individual psychotherapy" (p. 430). For example, instead of viewing the alliance individualistically, the therapeutic alliance must be considered in terms of the couple relationship (Rait, 2000), meaning that Attachment and the Therapeutic Alliance 217 the therapist's actions in joining with one member of the couple subsystem could have a simultaneous effect on the other member (Pinsof, Zinbarg, & Knobloch-Fedders, 2008). Thus, the therapist must focus on the relationship between himself and each client, as well as the relationship between the clients, which makes establishing an effective therapeutic alliance more difficult and complex.…”

Disentangling the change–alliance relationship: Observational assessment of the therapeutic alliance during change and stuck episodes

“…Webb et al (2011), found that the agreement on tasks and goals factor is a better predictor of symptomatic changes in CBT than the relationship factor (bond). Meanwhile, other studies found a positive relationship between the bond dimension of the alliance and outcome in interpersonal therapies (Wettersten, Lichtenberg, & Mallinckrodt, 2005), and between bond and clients' sense of well-being and decrease in symptoms (Pinsof, Zinbarg, & Knobloch-Fedders, 2008). Furthermore, Le Coco, Gullo, Prestano, and Gelso (2011), describe a positive significant relationship between clients' early assessment of authenticity of their relationship with their therapists and the bond dimension, and therapy outcome in brief psychodynamic therapies.…”