‘One step up, but not there yet’: using client feedback to optimise the therapeutic alliance in family therapy

Abstract

As research suggests that there is a strong link between the quality of the therapeutic alliance and the effectiveness of psychotherapy, family therapists should reflect on ways to improve the quality of the alliance. The systematic use of client feedback can be a rich resource as a response to the complexity of the alliance in the family therapy setting. In this paper the focus is on ways in which the client’s systematic feedback can contribute to an optimisation of the therapeutic alliance. We present the Dialogical Feedback Tool (DFT), a simple feedback instrument to be used especially in family therapy sessions in which young children are involved. A case study illustrates how the feedback of clients on their experiences in therapy can help therapists to better attune to family members' experiences and expectations about therapy. Practitioner points The therapeutic alliance in family therapy is complex, especially when children are involved Using a simple feedback instrument can help deal with the complexity of the therapeutic alliance The most important challenge for therapists using feedback instruments is how to integrate the feedback in a constructive way in the therapeutic process

Alliance discrepancies in home‐based family treatment: occurrence, development and the therapist’s perspective

“…Mihalo and Valenti, 2018;Van Hennik, 2020;Zilcha-Mano and Errazuriz, 2015). In doing so, it is recommended to pay particular attention to children's and adolescents' feedback on the alliance (for an example, see Rober, Van Tricht and Sundet, 2020). Our findings also demonstrate that differences in alliances with the therapist between family members are the rule rather than the exception.…”

Het beeldscherm als blikverruimer: een speelse respons op de uitdagingen van online therapie voor kinderen en gezinnen

“…We zorgen ook voor een sfeer met veel feedbackmogelijkheden (Rober et al. 2020 ), door middel van stroken gekleurd papier (groen, geel, rood) of emoticons, waardoor we voorkomen dat we verstrikt raken in een verbale pingpongsessie zonder emotionele lading, of in een situatie waarin kind en gezin het idee krijgen in een verhoor te zijn beland. Het is ook belangrijk om op voorhand af te spreken wat te doen als het kind of de volwassene van streek zou raken, zou gaan huilen, of boos of emotioneel zou worden.…”

Cultural reflexivity and the referral problem: A discourse analysis of three initial sessions of intercultural couple therapy

“…In addition, the use of naturally occurring video material within clinical supervision can provide opportunities to examine the micro‐practices of spoken and embodied communication, leading to greater critical awareness of one's contributions to therapy dialogues (Helps, 2021). Likewise, the routine use of client feedback may achieve greater awareness of alignment issues and help therapists scrutinise their practice when working individually (Rober et al, 2021). These systemic tools can help identify and repair ruptures, especially in early alliance building.…”