Predicting premature termination with alliance at sessions 1 and 3: an exploratory study

Abstract

Research has demonstrated that the therapeutic alliance is associated with termination status and treatment outcomes regardless of therapy models and the number of people involved in the treatment. Compared to individual therapy, however, relatively less attention has been paid to the therapeutic alliance as a predictor of premature termination of couple and family therapy. In the current study, videotape recordings of two samples of couples in therapy – one in the first session and the other in the third session – were analysed to examine the association between the therapeutic alliance and termination status. A total of 34 videotapes were analysed in this exploratory study. All the tapes were rated for the therapeutic alliance using the Vanderbilt therapeutic alliance scale, which allowed observers to code behaviour and interactions between couples and their therapist. The results of this study, though preliminary, suggested that the therapeutic alliance measured at the first session was more predictive of premature termination than was the alliance at the third session, which somewhat challenges findings from studies of individual psychotherapy.Practitioner points Assessing the therapeutic alliance in the first couple therapy session may be more important in predicting later premature termination than in the third session. In particular, new therapists in training may need to pay special attention to their alliance with clients from the very beginning of therapy.