Research on the therapeutic alliance in family therapy

Abstract

This chapter discusses research that highlights the strong relationship between the therapeutic alliance and outcome in marital and family therapy. The primary frame of reference for this aspect of the work is observing systems. Since it is possible to co-construct multiple formulations to explain any problem or exception to it, it is important to have a criterion by which to judge the merit of any particular one. Studies of couples therapy consistently show that the quality of the therapeutic alliance or the client–therapist relationship reported by clients during therapy is associated with therapeutic outcome. Convening whole family sessions where adolescents have drug problems or adults have alcohol problems can be very challenging. Systemic interventions are particularly effective in helping families whose members have substance use problems engage in therapy and maintain an ongoing therapeutic relationship. There is evidence that certain practices can pre-empt clients’ negative reactions to teams and one-way screens.