Toward a broader understanding of split alliances in family therapy: Adding the therapist to the mix

Abstract

To broaden our understanding of a split alliance in family therapy, we investigated the frequencies and correlates of sessions in which therapists, youth, and caregivers reported markedly different perceptions of the alliance. The sample consisted of 156 Spanish families who received Alliance Empowerment Family Therapy (Escudero, Adolescentes y familias en conflicto, 2013) for child maltreatment. Family members and therapists rated the alliance on the SOFTA‐s (Friedlander et al., Journal of Counseling Psychology, 2006, 53, 214) after sessions 3, 6, and 9; family members rated their perceptions of treatment progress before sessions 4, 7, and 10. A cluster analysis differentiated sessions with a split adult‐youth alliance (27.7%) from a split family‐therapist alliance (44.1%), and a balanced alliance (similar ratings across the three perspectives; 28.2%). Client‐rated treatment progress was differentially associated with the type of alliance split and the average alliance rating, whereas better posttreatment outcomes (child functioning and family goal attainment) were associated with fewer sessions having either type of split alliance.

How therapists respond to “uneven” alliances in couple and family therapy: A conversation‐analytic study

“…Importantly, however, balancing and repairing the alliance is done through the collaborative work of the therapist and the patient (e.g., Horvath, 2018). What is more, a systemic understanding of the alliance may be achieved by examining both the perspective of therapists and family members (Escudero et al, 2022). Therefore, leaving out the examination of clients' perception of the asymmetry of alliance is the main limitation of our study.…”

“…Importantly, despite the complexity of therapists' tasks while balancing multiple alliances, we do not have sufficient data on therapists' concrete behavioral manifestations of alliance (Friedlander et al, 2022) (but see Horvath & Muntigl, 2018; Muntigl & Horvath, 2016). What is more, little is known about therapists' perception of building alliances (Escudero et al, 2022). We aim to fill this gap by investigating the therapists' recognition of interactional manifestations of uneven alliances at the micro‐level of their management of alignments and affiliations.…”

Patterns and levels of engagement and conflict development and member outcome in adolescent counseling groups.

“…The interaction of average level of engagement and conflict and pattern of engagement and conflict development has not been theorized nor literature; however, Escudero et al (2022) examined the interaction of average level and pattern of alliance ratings in family therapy. They found that level and pattern alliance ratings interacted to predict session and treatment outcome.…”